Comparison of primary coronary stenting to primary balloon angioplasty with stent bailout for the treatment of patients with acute myocardial infarction
| Autor: | Lari C. Harrell, Igor F. Palacios, Nasser A Mahdi, Ik-Kyung Jang, Miltiadis N Leon, Julio Lopez, Asad Pathan |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Male
Reoperation medicine.medical_specialty medicine.medical_treatment Myocardial Infarction Revascularization Balloon Coronary Angiography Postoperative Complications Predictive Value of Tests Recurrence Internal medicine Angioplasty medicine Humans cardiovascular diseases Myocardial infarction Hospital Mortality Angioplasty Balloon Coronary Survival rate Retrospective Studies business.industry Stent Retrospective cohort study Middle Aged medicine.disease Surgery Survival Rate Predictive value of tests Cardiology Feasibility Studies Female Stents Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | The American journal of cardiology. 81(8) |
| ISSN: | 0002-9149 |
| Popis: | This study compares the immediate and long-term outcomes of a primary coronary stenting strategy with primary balloon angioplasty with stent bailout in the treatment of patients with acute myocardial infarction (AMI). One hundred forty-seven consecutive patients who underwent primary balloon angioplasty with stent bailout (n = 94) or primary stenting (n = 53) for AMI were clinically followed for 8.1 +/- 5.7 and 8.5 +/- 4.5 months, respectively. Immediate results, as well as in-hospital and long-term ischemic events (death, reinfarction, and repeat revascularization) were compared between both groups. Angiographic success was 91.5% in the balloon angioplasty group and 94% in the stent group. In-hospital and late follow-up combined ischemic events were 22 of 94 (23%) versus 0 of 53 (0%); p < 0.001 and 33 of 78 (42%) versus 13 of 53 (25%), p = 0.04 for the balloon angioplasty and stent groups, respectively. At 6 months, the cumulative probability of repeat target lesion revascularization was higher in the balloon angioplasty group (47% vs 18%, p = 0.0006) as was the probability of late target revascularization (36% vs 18%, p = 0.046); the cumulative event-free survival after 6 months was significantly lower in the balloon angioplasty group (44% vs 80%, p = 0.0001). This study demonstrates that a primary stent placement strategy in patients with AMI is safe, feasible, and superior to primary balloon angioplasty with stent bailout. Primary stenting results in a larger postprocedural minimal luminal diameter, a lower early and late recurrent ischemic event rate, and a lower incidence of target lesion revascularization at follow-up. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect