Resultados de la estrategia farmacoinvasiva y de la angioplastia primaria en la reperfusión del infarto con elevación del segmento ST. Estudio con resonancia magnética cardiaca en la primera semana y en el sexto mes

Autor: Vicente Bodi, Rafael San-Juan, David Moratal, Maria P. Lopez-Lereu, Àngel Llàcer, Francisco J. Chorro, Jose V. Monmeneu, Julio Núñez, Fabian Chaustre, Isabel Trapero, Ricardo Oltra, Pilar Merlos, Eva Rumiz, Maria L. Blasco, Juan Sanchis
Jazyk: angličtina
Rok vydání: 2011
Předmět:
Male
Cardiac Catheterization
Propensity score
medicine.medical_treatment
Left
Heart left ventricle
Coronary
Myocardial Infarction
Infarction
Magnetic resonance angiography
Ventricular Dysfunction
Left
Heart infarction size
Ventricular Dysfunction
Medicine
Thrombolytic Therapy
Myocardial infarction
Prospective Studies
Angioplasty
Balloon
Coronary
comparative study
education.field_of_study
Ejection fraction
medicine.diagnostic_test
General Medicine
Middle Aged
Magnetic Resonance Imaging
Thrombolysis
Death
Nuclear magnetic resonance imaging
Treatment Outcome
Heart left ventricle endsystolic volume
Cardiology
Female
TIMI
Human
medicine.medical_specialty
Heart Catheterization
Endpoint Determination
Fibrinolytic agent
Population
Myocardial Reperfusion Injury
Major clinical study
Article
TECNOLOGIA ELECTRONICA
Magnetic resonance imaging
Internal medicine
Angioplasty
Humans
Blood clot lysis
Prospective study
education
Primary angioplasty
Aged
University hospital
ST segment elevation myocardial infarction
business.industry
medicine.disease
Surgery
ST-segment elevation myocardial infarction
Outcome assessment
Heart catheterization
Reperfusion
Heart muscle reperfusion
business
Controlled study
Balloon
Magnetic Resonance Angiography
Follow-Up Studies
Zdroj: RiuNet. Repositorio Institucional de la Universitat Politécnica de Valéncia
instname
Popis: [EN] Introduction and objectives: Pharmacoinvasive strategy represents an attractive alternative to primary angioplasty. Using cardiovascular magnetic resonance imaging we compared the left ventricular outcome of the pharmacoinvasive strategy and primary angioplasty for the reperfusion of ST-segment elevation myocardial infarction. Methods: Cardiovascular magnetic resonance was performed 1 week and 6 months after infarction in two consecutive cohorts of patients included in a prospective university hospital ST-segment elevation myocardial infarction registry. During the period 2004-2006, 151 patients were treated with pharmacoinvasive strategy (thrombolysis followed by routine non-immediate angioplasty). During the period 2007-2008, 93 patients were treated with primary angioplasty. A propensity score matched population was also evaluated. Results: At 1-week cardiovascular magnetic resonance, pharmacoinvasive strategy and primary angioplasty patients showed a similar extent of area at risk (29 ± 15 vs. 29 ± 17%, P = .9). Non-significant differences were detected by cardiovascular magnetic resonance at 1 week and at 6 months in infarct size, salvaged myocardium, microvascular obstruction, ejection fraction, end-diastolic volume index and end-systolic volume index (P > .2 in all cases). The same trend was observed in 1-to-1 propensity score matched patients. The rate of major adverse cardiac events (death and/or re-infarction) at 1 year was 6% in pharmacoinvasive strategy and 7% in primary angioplasty patients (P = .7). Conclusions: A pharmacoinvasive strategy including thrombolysis and routine non-immediate angioplasty represents a widely available and logistically attractive approach that yields identical short-term and long-term cardiovascular magnetic resonance-derived left ventricular outcome compared to primary angioplasty. © 2010 Sociedad Española de Cardiología.
The present study was supported by the "Instituto de Salud Carlos III'' (PI080128 and Heracles grants).
Databáze: OpenAIRE
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