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Titolo:
Rescue-PTCA in acute myocardial infarction. Acute and long-term results
Autore:
Lapp, H; Krakau, I; Wolfertz, J; Ketteler, T; Ziegler, G; Boerrigter, G; Gulker, H;
Indirizzi:
Klinikum Wuppertal GmbH, Med Klin 3, D-42117 Wuppertal, Germany Klinikum Wuppertal GmbH Wuppertal Germany D-42117 117 Wuppertal, Germany
Titolo Testata:
MEDIZINISCHE KLINIK
fascicolo: 5, volume: 96, anno: 2001,
pagine: 247 - 255
SICI:
0723-5003(20010515)96:5<247:RIAMIA>2.0.ZU;2-B
Fonte:
ISI
Lingua:
GER
Soggetto:
TRANSLUMINAL CORONARY ANGIOPLASTY; THROMBOLYTIC THERAPY; FAILED THROMBOLYSIS; CARDIOGENIC-SHOCK; RANDOMIZED TRIAL; REPERFUSION; OUTCOMES; MORTALITY; ABCIXIMAB; FAILURE;
Keywords:
rescue-PTCA; acute myocardial infarction; procedural success; long-term results; cardiogenic shock; thrombolysis;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
45
Recensione:
Indirizzi per estratti:
Indirizzo: Lapp, H Klinikum Wuppertal GmbH, Med Klin 3, Arrenberger Str 20, D-42117 Wuppertal, Germany Klinikum Wuppertal GmbH Arrenberger Str 20 Wuppertal Germany D-42117
Citazione:
H. Lapp et al., "Rescue-PTCA in acute myocardial infarction. Acute and long-term results", MED KLIN, 96(5), 2001, pp. 247-255

Abstract

Background: The results from studies of coronary angioplasty after failed thrombosis (rescue-PTCA) in acute myocardial infarction are contradictory Long-term results were not presented till now. Therefore we analyzed the data from our registry of those patients whose acute and long-term results were available. Patients and methods: Data of 49 patients were analyzed who had been admitted for rescue-PTCA from other hospitals. Thrombolysis had to be started < 6 hours (mean 2.7 hows) from onset of symptoms. Rescue-PTCA bad robe completed within < 24 hours (mean 10.5 hours). 37 patients received streptokinase, seven rt-PA, three urokinase and two prourokinase. Electrocardiographic and clinical criteria were used to define failure of thrombolysis. The data of the acute results were from a prospective registry and the long-term results came from clinical follow-up visits and a questionnaire sent to the patients. Results: Mean age of the patients was 48.5 years (38-78 years), 45 male, nine patients in cardiogenic shock (18%), infarct related artery (IRA): RCA 22X, LAD 21X, LCX 5X, CABG 1X, single vessel disease 27X, multiple vessel disease 22X. Acute results: Initial IRA-TIMI flow 0 in 28 patients, 1 in twelve patients, 2 in 9 patients; after rescue-PTCA TIMI now 1 in one patient,2 in two patients, 3 in 46 patients (procedural success 94%). Hospital mortality 8.2% (four patients), all in cardiogenic shock. Early reocclusion rate 10%. Bleeding complications 14%, no fatal complications. Long-term results: Observation period 2.5 years in 42 patients (0.5-6.5 years). Three moredeaths. Total mortality 14% (7/49). Angiographic follow-up: Ejection fraction initially 50%; 53% after months. Repeat revascularization in 43% (15/35). Re-PTCA in 8/35, surgery in 6/35 patients, 1 X transplantation. 80% of the patients were free from angina or heart failure. Conclusions: Rescue-PTCA in acute myocardial infarction has a high procedural success rate with a low hospital mortality. It is the treatment of choice for patients in cardiogenic shock. Transportation to an interventional center is safe. The reintervention rate is comparably high. The long-term results are good.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 19/01/20 alle ore 20:44:39