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Titolo:
Infarct artery reocclusion after primary angioplasty, stent placement, andthrombolytic therapy for acute myocardial infarction
Autore:
Wilson, SH; Bell, MR; Rihal, CS; Bailey, KR; Holmes, DR; Berger, PB;
Indirizzi:
Mayo Clin, Div Cardiovasc Dis, Rochester, MN 55905 USA Mayo Clin Rochester MN USA 55905 Cardiovasc Dis, Rochester, MN 55905 USA
Titolo Testata:
AMERICAN HEART JOURNAL
fascicolo: 5, volume: 141, anno: 2001,
pagine: 704 - 710
SICI:
0002-8703(200105)141:5<704:IARAPA>2.0.ZU;2-A
Fonte:
ISI
Lingua:
ENG
Soggetto:
PRIMARY BALLOON ANGIOPLASTY; CORONARY ANGIOPLASTY; UNSTABLE ANGINA; STREPTOKINASE; TRIAL; IMPLANTATION; REPERFUSION; DISSECTION; THROMBUS; COUMADIN;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
39
Recensione:
Indirizzi per estratti:
Indirizzo: Berger, PB Mayo Clin, Div Cardiovasc Dis, 200 1st St SW, Rochester, MN 55905 USA Mayo Clin 200 1st St SW Rochester MN USA 55905 er, MN 55905 USA
Citazione:
S.H. Wilson et al., "Infarct artery reocclusion after primary angioplasty, stent placement, andthrombolytic therapy for acute myocardial infarction", AM HEART J, 141(5), 2001, pp. 704-710

Abstract

Background The benefits of thrombolytic therapy for acute myocardial infarction (AMI) are limited by reocclusion of the infarct-related artery, whichoccurs in 25% to 30% of patients after successful reperfusion. The frequency of reocclusion after balloon angioplasty and stenting in this setting isless well documented. The aim of this study was to analyze the frequency and timing of reocclusion alter percutaneous transluminal coronary angioplasty (PTCA) and stent placement during AMI from all available studies compared with previously published reocclusion rates after thrombolysis. Methods and Results The previously published thrombolysis data included 4231 patients in 19 studies with greater than or equal to 75 patients. Only PTCA studies with greater than or equal to 50 patients and stent studies with greater than or equal to 30 patients, in which routine angiographic follow-up was obtained in greater than or equal to 60% of patients, were included. Ten PTCA studies with a total of 1943 patients were analyzed, with follow-up angiography in 1391 (72%). Reocclusion rates ranged from 5% to 16.7%. The stent studies included 698 patients from 7 studies, with follow-up angiography in 92%. Reocclusion rates ranged from 0% to 6%. With the use of logistic regression analysis with allowance for overdispersion, there was a significantly lower rate of reocclusion after PTCA (odds ratio, 0.38; confidence interval, 0.24 to 0.57; P < .0001) and stent placement (odds ratio, 0.11; confidence interval, 0.05 to 0.22; P < .0001) compared with thrombolysis. Reocclusion after stent placement was lower than after PTCA (odds ratio, 0.28; confidence interval, 0.13 to 0.6; P < .0001). Conclusions Reocclusion after PTCA and stent placement during AMI is less frequent than after thrombolysis. This may contribute to the superior outcome of patients treated with PTCA end stent placement in this setting.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 13/07/20 alle ore 18:03:09