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Titolo:
Impact of prehospital delay on mortality in patients with acute myocardialinfarction treated with primary angioplasty and intravenous thrombolysis
Autore:
Zahn, R; Schiele, R; Gitt, AK; Schneider, S; Seidl, K; Voigtlander, T; Gottwik, M; Altmann, E; Gieseler, U; Rosahl, W; Wagner, S; Senges, J;
Indirizzi:
Herzzentrum Ludwigshafen, Dept Cardiol, D-67063 Ludwigshafen, Germany Herzzentrum Ludwigshafen Ludwigshafen Germany D-67063 wigshafen, Germany Univ Mainz, D-6500 Mainz, Germany Univ Mainz Mainz Germany D-6500Univ Mainz, D-6500 Mainz, Germany Klinikum Nurnberg, Nurnberg, Germany Klinikum Nurnberg Nurnberg GermanyKlinikum Nurnberg, Nurnberg, Germany Klinikum Friedrichstadt, Dresden, Germany Klinikum Friedrichstadt Dresden Germany riedrichstadt, Dresden, Germany Diakonissenkrankenhaus Speyer, Speyer, Germany Diakonissenkrankenhaus Speyer Speyer Germany us Speyer, Speyer, Germany Stadt Klinikum, Dessau, Germany Stadt Klinikum Dessau GermanyStadt Klinikum, Dessau, Germany Furst Stirum Klin, Bruchsal, Germany Furst Stirum Klin Bruchsal GermanyFurst Stirum Klin, Bruchsal, Germany
Titolo Testata:
AMERICAN HEART JOURNAL
fascicolo: 1, volume: 142, anno: 2001,
pagine: 105 - 111
SICI:
0002-8703(200107)142:1<105:IOPDOM>2.0.ZU;2-6
Fonte:
ISI
Lingua:
ENG
Soggetto:
LEFT-VENTRICULAR FUNCTION; SYMPTOM-ONSET; PLASMINOGEN-ACTIVATOR; CORONARY ANGIOPLASTY; REGISTRY MIR; GUSTO-IIB; THERAPY; TIME; SIZE; REPERFUSION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
31
Recensione:
Indirizzi per estratti:
Indirizzo: Zahn, R Herzzentrum Ludwigshafen, Dept Cardiol, Bremserstr 79, D-67063 Ludwigshafen, Germany Herzzentrum Ludwigshafen Bremserstr 79 Ludwigshafen Germany D-67063
Citazione:
R. Zahn et al., "Impact of prehospital delay on mortality in patients with acute myocardialinfarction treated with primary angioplasty and intravenous thrombolysis", AM HEART J, 142(1), 2001, pp. 105-111

Abstract

Background In patients with acute myocardial infarction treated with thrombolysis, longer times to treatment are associated with increasingly worse clinical outcome. This relation may be different For treatment with primary angioplasty. Methods We analyzed the pooled data of the German acute myocardial infarction registries Maximal Individual Therapy in Acute Myocardial Infarction (MITRA) and Myocardial Infarction Registry (MIR) to determine the influence of prehospital delays on hospital mortality rates. Primary angioplasty was performed in 1063 patients and thrombolysis in 7552 patients. Results In patients treated with thrombolysis, in-hospital time to treatment was constantly 30 minutes median. In patients treated with primary angioplasty, in-hospital time to treatment increased from 60 minutes median up to 87 minutes median with increasing prehospital delay. Hospital mortality rates slightly decreased with increasing prehospital delays in patients treated with primary angioplasty (P for trend =.02). However, in patients treated with thrombolysis, mortality rate was nonsignificantly increased (P for trend =.11). Logistic regression analysis showed no significant difference in mortality rates between primary angioplasty and thrombolysis for prehospital delays of <3 hours. However, when prehospital delay was 23 hours, thrombolysis was independently associated with a higher mortality rate comparedwith primary angioplasty. Conclusions Compared with thrombolysis, primary angioplasty is independently associated with a lower mortality rate in prehospital delays of 23 hours. The reason for this may be a time-dependent loss of efficacy to achieve reperfusion for thrombolysis but not for primary angioplasty.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/03/20 alle ore 00:34:45