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Titolo:
Does the presence of thrombus seen on a coronary angiogram affect the outcome after percutaneous coronary angioplasty? An Angiographic Trials Pool data experience
Autore:
Singh, M; Reeder, GS; Ohman, EM; Mathew, V; Hillegass, WB; Anderson, RD; Gallup, DS; Garratt, KN; Holmes, DR;
Indirizzi:
Mayo Clin & Mayo Fdn, Div Internal Med & Cardiovasc Dis, Rochester, MN 55905 USA Mayo Clin & Mayo Fdn Rochester MN USA 55905 Dis, Rochester, MN 55905 USA Duke Univ, Med Ctr, Duke Clin Res Inst, Durham, NC USA Duke Univ Durham NC USA niv, Med Ctr, Duke Clin Res Inst, Durham, NC USA
Titolo Testata:
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
fascicolo: 3, volume: 38, anno: 2001,
pagine: 624 - 630
SICI:
0735-1097(200109)38:3<624:DTPOTS>2.0.ZU;2-I
Fonte:
ISI
Lingua:
ENG
Soggetto:
DIRECTIONAL ATHERECTOMY; INTRACORONARY THROMBUS; MYOCARDIAL-INFARCTION; VESSEL CLOSURE; MULTICENTER; RISK; OCCLUSION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
20
Recensione:
Indirizzi per estratti:
Indirizzo: Holmes, DR Mayo Clin & Mayo Fdn, Div Internal Med & Cardiovasc Dis, 200 1st St SW, Rochester, MN 55905 USA Mayo Clin & Mayo Fdn 200 1st St SW Rochester MN USA 55905 5 USA
Citazione:
M. Singh et al., "Does the presence of thrombus seen on a coronary angiogram affect the outcome after percutaneous coronary angioplasty? An Angiographic Trials Pool data experience", J AM COL C, 38(3), 2001, pp. 624-630

Abstract

OBJECTIVES This study aimed to determine whether pre-existing angiographicthrombus was associated with adverse in-hospital and six-month outcomes after percutaneous coronary interventions. BACKGROUND There are conflicting data about whether pre-existing thrombus is an independent predictor of adverse in-hospital and short-term outcome after coronary interventions. METHODS The Angiographic Trials Pool, a data set derived from eight prospective randomized trials, was analyzed. The study population consisted of 7,917 patients who underwent coronary interventions between 1986 and 1995. Two trials were excluded because they did not collect information regarding thrombus. Patients from the other six trials were divided on the basis of the presence or absence of thrombus. RESULTS In patients with (n = 2,752) and without (5,165) thrombus, in-hospital mortality following angioplasty was low (0.8 vs. 0.6%, p = 0.207). Several adverse outcomes were higher in patients with thrombus: death/myocardial infarction (8.4 vs. 5.5%, p less than or equal to 0.001), in-hospital abrupt closure (5.9 vs. 3.9%, p less than or equal to 0.001) and an in-hospital composite of death, myocardial infarction and/or repeat revascularization (15.4 vs. 11.2%, p :5 0.001). Six-month mortality was low and comparable between the two groups (2.1 vs. 1.8%, p = 0.34), but the incidence of six-month death/myocardial infarction was higher in patients with thrombus (11.7vs. 8.7%, p less than or equal to 0.0001). CONCLUSIONS Percutaneous coronary angioplasty can be performed with low mortality in patients with pre-existing thrombus, although these patients areat higher risk of in-hospital and six-month death/myocardial infarction. Continued efforts are required to optimize the outcome in these high risk patients. (C) 2001 by the American College of Cardiology.

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Documento generato il 14/07/20 alle ore 19:17:03