761-5 Evolution of Angiographic Thrombus Formation and Dissection Following PTCA in Unstable Angina
| Autor: | John A. Ambrose, Orlandino D. Almeida, Sabino Torre, Denise E. Ratner, Jonathan D. Marmur, Douglas H. Israel, Samin K. Sharma |
|---|---|
| Rok vydání: | 1995 |
| Předmět: |
Urokinase
medicine.medical_specialty business.industry Unstable angina Balloon medicine.disease Placebo Dissection surgical procedures operative Internal medicine Time course Cardiology Medicine cardiovascular diseases Thrombus business Adverse effect Cardiology and Cardiovascular Medicine medicine.drug |
| Zdroj: | Journal of the American College of Cardiology. 25(2) |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/0735-1097(95)92581-o |
| Popis: | Acute closure and adverse in hospital clinical events are increased following PTCA in unstable angina. Both thrombus (T) and dissection (D) post PTCA are associated with increased adverse events. However, the time course of development of T or D post PTCA has not been studied. In the TAUSA trial, unstable angina patients were blindly randomized to intracoronary Urokinase or placebo administered during and immediately following PTCA of the culprit lesion. Angiograms were read blindly by a core lab and characterized at 1 a 15 minutes following PTCA for T or D. D was divided into minor (linear extraluminal cap without luminal compromise) and major (spiral D or D causing g 50% diameter reduction). T was defined as one or more filling defects at the PTCA site. Thrombus Major Dissection 1 min. 15 min. 1 min. 15 min. All pts (n = 459) 4.4% 14.8% * 6.7% 9.2% Urokinase (n = 226) 4.1% 11.9% * 5.9% † 10.1%t Placebo (n = 233) 4.8% 17.5% * 7.4% 8.3% * p l 0.00515 min. vs. 1 min. † p = 0.10 15 min. vs 1 min.; all other NS For all pts and for Urokinase and Placebo, angiographic T increased at 15 vs. 1 min post PTCA. There was a trend to an increase in major D with Urokinase at 15 min but not in the placebo group. Any D (major or minor) was noted with placebo in 24% and 29% at 1 and 15 min. respectively and in 27% and 32% with Urokinase, p = NS. Thus, T formation develops gradually following PTCA and is time dependent probably related to activation of coagulation. D is usually present immediately after PTCA secondary to the mechanical trauma of balloon’ dilatation. Urokinase given immediately after PTCA may increase the evolution to major D. |
| Databáze: | OpenAIRE |
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