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Titolo:
Improved survival of patients with acute myocardial infarction with significant left ventricular dysfunction undergoing invasive coronary procedures
Autore:
Rott, D; Behar, S; Hod, H; Feinberg, MS; Boyko, V; Mandelzweig, L; Kaplinsky, E; Gottlieb, S;
Indirizzi:
Chaim Sheba Med Ctr, Neufeld Cardiac Res Inst, IL-52621 Tel Hashomer, Israel Chaim Sheba Med Ctr Tel Hashomer Israel IL-52621 21 Tel Hashomer, Israel Bikur Cholim Hosp, Heiden Dept Cardiol, Jerusalem, Israel Bikur Cholim Hosp Jerusalem Israel iden Dept Cardiol, Jerusalem, Israel
Titolo Testata:
AMERICAN HEART JOURNAL
fascicolo: 2, volume: 141, anno: 2001,
pagine: 267 - 276
SICI:
0002-8703(200102)141:2<267:ISOPWA>2.0.ZU;2-8
Fonte:
ISI
Lingua:
ENG
Soggetto:
GUSTO-I TRIAL; CARDIOGENIC-SHOCK; EARLY REVASCULARIZATION; PLASMINOGEN-ACTIVATOR; THROMBOLYTIC THERAPY; EJECTION FRACTION; PHASE-II; CONSERVATIVE MANAGEMENT; REPERFUSION THERAPY; RANDOMIZED TRIAL;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
29
Recensione:
Indirizzi per estratti:
Indirizzo: Gottlieb, S Chaim Sheba Med Ctr, Neufeld Cardiac Res Inst, IL-52621 Tel Hashomer, Israel Chaim Sheba Med Ctr Tel Hashomer Israel IL-52621 mer, Israel
Citazione:
D. Rott et al., "Improved survival of patients with acute myocardial infarction with significant left ventricular dysfunction undergoing invasive coronary procedures", AM HEART J, 141(2), 2001, pp. 267-276

Abstract

Background Acute myocardial infarction (AMI) associated with significant left ventricular dysfunction (LVD) indicates a poor prognosis. Previous studies suggested that revascularization improves survival of patients with AMIcomplicated by cardiogenic shock. However, other studies that suggested that revascularization improves survival of stable patients with significant LVD did not specifically address patients who had recently had an AMI. Objectives our purpose was ia determine whether patients with thrombolytis-treated AMI associated with significant LVD are likely to incur a survivaladvantage from catheterization and coronary revascularization performed within 30 days after AMI. Methods The study population was drawn from the Argatroban in Acute Myocardial Infarction-2 (ARGAMI-2) trial, which included 1200 patients with AMI, all of whom received thrombolytic therapy. Our analysis included 737 patients for whom LV function was estimated by echocardiography. Two hundred two patients had significant LVD; of them, 117 (58%) underwent cardiac catheterization and 85 were treated noninvasively. Among 535 patients without significant LVD, 291 (54%) underwent cardiac catheterization and 244 were treated noninvasively,Results: Compared with a noninvasive approach, an invasive approach resulted in reduced 30-day and 6-month mortality rates in patients with significant LVD: 4.3% versus 10.6%, adjusted odds ratio (OR) 0.26, 95% confidence interval (CI) 0.04 to 1.18, and 6.1% versus 15.5%, OR 0.27, 95% CI 0.06 to 0.98, respectively. A similar comparison in patients without significant LVD resulted in comparable 30-day and 6-month mortality rates for both patient groups: invasively versus noninvasively treated, 0.7% versus 0.8%, OR 1.04,95% CI 0.04 to 12.7, and 1.4% versus 1.7%, adjusted OR 1.60, 95% CI 0.20 to 9.87. Conclusions The current study suggests that AMI patients with significant LVD may benefit from cardiac catheterization and revascularization performed early after AMI, whereas in patients without significant LVD the outcome of those treated invasively or conservatively was similar.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 26/01/20 alle ore 01:24:04