Safety and efficacy of percutaneous coronary interventions performed immediately after diagnostic catheterization in northern New England and comparison with similar procedures performed later
| Autor: | Samuel J. Shubrooks, David J. Malenka, John F. Robb, Thomas J. Ryan, Winthrop D Piper, Paul D McGrath, Matthew W. Watkins, Theodore M Silver, Daniel J. O'Rourke, Mirle A. Kellett, Peter VerLee, William A. Bradley, David E. Wennberg, Michael A Hearne, Bruce D. Hettleman, John R. O’Meara |
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| Rok vydání: | 2000 |
| Předmět: |
Atherectomy
Coronary Male Cardiac Catheterization medicine.medical_specialty medicine.medical_treatment Population Myocardial Infarction Angina Pectoris Atherectomy Coronary artery bypass surgery New England Risk Factors Internal medicine Angioplasty Humans Medicine Hospital Mortality Myocardial infarction Angioplasty Balloon Coronary Coronary Artery Bypass education Cardiac catheterization education.field_of_study business.industry Incidence Middle Aged medicine.disease Diagnostic catheterization Surgery Survival Rate Treatment Outcome Massachusetts Conventional PCI Cardiology Female Stents Safety Cardiology and Cardiovascular Medicine business |
| Zdroj: | The American Journal of Cardiology. 86:41-45 |
| ISSN: | 0002-9149 |
| DOI: | 10.1016/s0002-9149(00)00826-2 |
| Popis: | "Ad hoc" percutaneous coronary interventions (PCIs)-those performed immediately after diagnostic catheterization-have been reported in earlier studies to be safe with a suggestion of higher risk in certain subgroups. Despite increasing use of this strategy, no data are available in recent years with new device technology. We studied use of an ad hoc strategy in a large regional population to determine its use and outcomes compared with staged procedures. A database from the 6 centers performing PCIs in northern New England and 1 center in Massachusetts was analyzed. During 1997, excluding only patients requiring emergency procedures or those with a prior PCI, 4,136 PCIs were performed, 1,748 (42.3%) of these being ad hoc procedures. Patients having ad hoc procedures were less likely to have peripheral vascular disease, renal failure, prior myocardial infarction, or coronary artery bypass surgery, congestive heart failure, or poor left ventricular function, and more likely to have received preprocedural intravenous heparin or nitroglycerin or to have required an urgent procedure. Narrowings treated during ad hoc procedures were less frequently types B and C or in saphenous vein grafts. Adjusted rates of clinical success were not different between ad hoc and non-ad hoc procedures (93.7% vs 93.6%); there was no difference in the incidence of death (0.6% vs 0.5%), emergency (0. 9% vs 0.8%) or any (1.4% vs 0.8%) coronary artery bypass surgery, or myocardial infarction (2.6% vs 2.0%). As currently practiced in our region, ad hoc intervention is used selectively with outcomes similar for ad hoc and non-ad hoc procedures. |
| Databáze: | OpenAIRE |
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