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Titolo:
Long-term outcome after primary angioplasty: Report from the Primary Angioplasty in Myocardial Infarction (PAMI-I) Trial
Autore:
Nunn, CM; ONeill, WW; Rothbaum, D; Stone, GW; OKeefe, J; Overlie, P; Donohue, B; Grines, L; Browne, KF; Vlietstra, RE; Catlin, T; Grines, CL;
Indirizzi:
Waikato Hosp, Div Cardiol, Hamilton, New Zealand Waikato Hosp Hamilton New Zealand p, Div Cardiol, Hamilton, New Zealand William Beaumont Hosp, Div Cardiol, Royal Oak, MI 48072 USA William Beaumont Hosp Royal Oak MI USA 48072 iol, Royal Oak, MI 48072 USA St Vincent Hosp, Div Cardiol, Indianapolis, IN USA St Vincent Hosp Indianapolis IN USA p, Div Cardiol, Indianapolis, IN USA El Camino Hosp, Div Cardiol, Mountain View, CA USA El Camino Hosp Mountain View CA USA , Div Cardiol, Mountain View, CA USA Mid Amer Heart Inst, Div Cardiol, Kansas City, MO 64111 USA Mid Amer HeartInst Kansas City MO USA 64111 l, Kansas City, MO 64111 USA St Mary Plains, Div Cardiol, Lubbock, TX USA St Mary Plains Lubbock TX USA Mary Plains, Div Cardiol, Lubbock, TX USA Allegheny Gen Hosp, Div Cardiol, Pittsburgh, PA 15212 USA Allegheny Gen Hosp Pittsburgh PA USA 15212 diol, Pittsburgh, PA 15212 USA Lakeland Reg Med Ctr, Div Cardiol, Lakeland, FL USA Lakeland Reg Med Ctr Lakeland FL USA Ctr, Div Cardiol, Lakeland, FL USA
Titolo Testata:
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
fascicolo: 3, volume: 33, anno: 1999,
pagine: 640 - 646
SICI:
0735-1097(19990301)33:3<640:LOAPAR>2.0.ZU;2-I
Fonte:
ISI
Lingua:
ENG
Soggetto:
PRIMARY CORONARY ANGIOPLASTY; CATHETERIZATION LABORATORY EVENTS; TISSUE PLASMINOGEN-ACTIVATOR; THROMBOLYTIC THERAPY; INTRAVENOUS STREPTOKINASE; IMMEDIATE ANGIOPLASTY; CLINICAL-TRIAL; DISEASE; ARTERY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
31
Recensione:
Indirizzi per estratti:
Indirizzo: Nunn, CM Waikato Hosp, Div Cardiol, Private Bag 3200, Hamilton, New Zealand Waikato Hosp Private Bag 3200 Hamilton New Zealand New Zealand
Citazione:
C.M. Nunn et al., "Long-term outcome after primary angioplasty: Report from the Primary Angioplasty in Myocardial Infarction (PAMI-I) Trial", J AM COL C, 33(3), 1999, pp. 640-646

Abstract

OBJECTIVES This study sought to compare the two-year outcome after primarypercutaneous coronary angioplasty or thrombolytic therapy for acute myocardial infarction. BACKGROUND Primary angioplasty, that is, angioplasty without antecedent thrombolytic therapy, has been shown to be an effective reperfusion modality for patients suffering an acute myocardial infarction. This report reviews the two-year clinical outcome of patients randomized in the Primary Angioplasty in Myocardial Infarction trial. METHODS At 12 clinical centers, 395 patients who presented within 12 h of the onset of myocardial infarction were randomized to undergo primary angioplasty (195 patients) or to receive tissue-type plasminogen activator (t-PA) (200 patients) followed by conservative care. Patients were followed by physician visits, phone call, letter and review of hospital records for any hospital admission at one month, six months, one year and two years. RESULTS At two years, patients undergoing primary angioplasty had less recurrent ischemia (36.4% vs. 48% for t-PA, p = 0.026), lower reintervention rates (27.2% vs. 46.5% for t-PA, p < 0.0001) and reduced hospital readmission rates (58.5% vs. 69.0% for t-PA, p = 0.035). The combined end point of death or reinfarction was 14.9% for angioplasty versus 23% for t-PA, p = 0.034. Multivariate analysis found angioplasty to be independently predictive of a reduction in death, reinfarction or target vessel revascularization (p = 0.0001). CONCLUSIONS The initial benefit of primary angioplasty performed by experienced operators is maintained over a two-year follow-up period with improved infarct-free survival and reduced rate of reintervention. (C) 1999 by theAmerican College of Cardiology.

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Documento generato il 05/04/20 alle ore 07:10:44