Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
Coronary angioplasty in acute myocardial infarction: in which patients is it less likely to obtain an adequate coronary reperfusion?
Autore:
Moreno, R; Garcia, E; Soriano, J; Abeytua, M; Martinez-Selles, M; Acosta, J; Elizaga, J; Botas, J; Rubio, R; de Sa, EL; Lopez-Sendon, JL; Delcan, JL;
Indirizzi:
Hosp Gen Gregorio Maranon, Dept Cardiol, E-28007 Madrid, Spain Hosp Gen Gregorio Maranon Madrid Spain E-28007 ol, E-28007 Madrid, Spain
Titolo Testata:
REVISTA ESPANOLA DE CARDIOLOGIA
fascicolo: 9, volume: 53, anno: 2000,
pagine: 1169 - 1176
SICI:
0300-8932(200009)53:9<1169:CAIAMI>2.0.ZU;2-M
Fonte:
ISI
Lingua:
SPA
Soggetto:
NO-REFLOW PHENOMENON; THROMBOLYTIC THERAPY; IMMEDIATE ANGIOPLASTY; CLINICAL IMPLICATIONS; CARDIOGENIC-SHOCK; ARTERY DISEASE; PREDICTORS; COMPLICATIONS; PROGNOSIS; MORTALITY;
Keywords:
coronary angioplasty; acute myocardial infarction;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
57
Recensione:
Indirizzi per estratti:
Indirizzo: Garcia, E Hosp Gen Gregorio Maranon, Serv Hemodinam & Cardiol Intervencionista, Doctor Esquerdo 46, E-28007 Madrid, Spain Hosp Gen Gregorio Maranon Doctor Esquerdo 46 Madrid Spain E-28007
Citazione:
R. Moreno et al., "Coronary angioplasty in acute myocardial infarction: in which patients is it less likely to obtain an adequate coronary reperfusion?", REV ESP CAR, 53(9), 2000, pp. 1169-1176

Abstract

Introduction. In patients with acute myocardial infarction treated with primary angioplasty, the inability to achieve successful coronary reperfusionis associated with higher mortality. The objective of the study was to identify which characteristics may predict a lower angiographic success rate in patients with acute myocardial infarction treated with coronary angioplasty. Patients and methods. The study population is constituted by the 790 patients with acute myocardial infarction that were treated with angioplasty within the 12 hours after the onset of symptoms from 1991 to 1999 at our institution. A successful anigographic result was considered in presence of a residual stenosis <50% and a TIMI flow 2 or 3 after the procedure. Results. A successful angiographic result and a final TIMI 3 flow were achieved in 736 (93.2%) and 652 (82.5%) patients, respectively. In-hospital mortality was higher in patients with angiographic failure than in those withangiographic successful result (48 vs. 10%; p < 0.01). Age under 65 (91 vs. 95%; p = 0.02), non smoking (90 vs. 96%; p < 0.01), previous infarction (87 vs. 94%; p = 0.02), cardiogenic shock (80 vs. 95%; p < 0.01), undetermined location (67 vs. 93%; p < 0.01), non-inferior location (92 vs. 96%; p = 0.04), left bundle branch block (64 vs. 94%; p < 0.01), multivessel disease(91 vs. 95%; p = 0.02), left ventricular ejection fraction < 0.40 (89 vs. 97%; p < 0.01), no utilization of coronary stenting (90 vs 96%; p < 0.01), and use of intraaortic balloon couterpulsation pump (82 vs. 95%; p < 0.01) were associated with a lower angiographic success rate. In the multivariable analysis, the following were independent predictors for angiographic failure: left bundle branch block (odds ratio [OR], 12.95; CI 95%, 3.00-53.90),cardiogenic shock (OR, 4.20; CI 95%, 1.95-8.75), no utilization of coronary stent (OR, 3.44; CI 95%, 1.71-7.37), and previous infarction (OR, 2.82; CI 95%, 1.29-5.90). Conclusion. Coronary angioplasty allows a successful coronary recanalization in most patients with acute myocardial infarction. Some basic characteristics, however, may identify some subsets in which a successful angiographic result may be more difficult to obtain.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 23/01/20 alle ore 12:16:15