Early and late results of coronary angioplasty without antecedent thrombolytic therapy for acute myocardial infarction

O’Keefe, James H.; Rutherford, Barry D.; McConahay, David R.; Ligon, Robert W.; Johnson, Warren L.; Giorgi, Lee V.; Crockett, James E.; McCallister, Ben D.; Conn, Robert D.; Gura, George M.; Good, Thomas H.; Steinhaus, David; Bateman, Timothy M.; Shimshak, Thomas M.; Hartzler, Geoffrey O.

doi:10.1016/0002-9149(89)90558-4

Cited by 225 publications

(35 citation statements)

References 33 publications

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“…The success rate of angioplasty in this study (95%) was similar to that in other series [10,11] ; however, in our study, no patient underwent emergency bypass surgery following unsuccessful PCI.…”

Section: Discussionsupporting

confidence: 90%

Outcomes of Primary Percutaneous Coronary Intervention in Acute Myocardial Infarction at Tehran Heart Center

Alidoosti

Salarifar²,

Haji-Zeinali³

et al. 2007

Med Princ Pract

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Section: Discussionsupporting

confidence: 90%

Outcomes of Primary Percutaneous Coronary Intervention in Acute Myocardial Infarction at Tehran Heart Center

Alidoosti

Salarifar²,

Haji-Zeinali³

et al. 2007

Med Princ Pract

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“…A sample size of 1100 patients with an average follow-up of at least 1.5 years was selected based on the assumptions that the incidence of the primary end point is approximately 5 per 100 person years 14 and that 10 end points per risk predictor investigated are on hand. 15 To accomplish a valid analysis even in the case of a lower mortality rate than anticipated or to account for loss to follow-up, the sample size was increased by 300 patients.…”

Section: Discussionmentioning

confidence: 99%

“…17 Multivariate analyses were performed using the Cox proportional-hazards model. 14 The effects of the factors investigated are given as hazard ratios with 95% CIs. Tests in the Cox model and log-rank tests were 2-sided, and comparisons of sensitivity and positive predictive accuracy were 1-sided.…”

Section: Discussionmentioning

confidence: 99%

Risk Stratification After Acute Myocardial Infarction by Heart Rate Turbulence

Barthel¹,

Schneider²,

Bauer³

et al. 2003

Circulation

221

214

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Background-Retrospective postinfarction studies revealed that decreased heart rate turbulence (HRT) indicates increased risk for subsequent death. This is the first prospective study to validate HRT in a large cohort of the reperfusion era. Methods and Results-One thousand four hundred fifty-five survivors of an acute myocardial infarction (age Ͻ76 years) in sinus rhythm were enrolled. HRT onset (TO) and slope (TS) were calculated from Holter records. Patients were classified into the following HRT categories: category 0 if both TO and TS were normal, category 1 if either TO or TS was abnormal, or category 2 if both TO and TS were abnormal. The primary end point was all-cause mortality. During a follow-up of 22 months, 70 patients died. Multivariately, HRT category 2 was the strongest predictor of death (hazard ratio, 5.9; 95% CI, 2.9 to 12.2), followed by left ventricular ejection fraction (LVEF) Յ30% (4.5; 2.6 to 7.8), diabetes mellitus (2.5; 1.6 to 4.1), age Ն65 years (2.4; 1.5 to 3.9), and HRT category 1 (2.4; 1.2 to 4.9). LVEF Յ30% had a sensitivity of 27% at a positive predictive accuracy level of 23%. The combined criteria of LVEF Յ30%, HRT category 2 or LVEF Ͼ30%, age Ն65 years, diabetes mellitus, and HRT category 2 had a sensitivity of 24% at a positive predictive accuracy level of 37%. The combined criteria of LVEF Յ30% or LVEF Ͼ30%, age Ն65 years, diabetes mellitus, and HRT category 1 or 2 had a sensitivity of 44% at a positive predictive accuracy level of 23%. Conclusions-HRT is a strong predictor of subsequent death in postinfarction patients of the reperfusion era. (Circulation.

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“…Early and sustained patency of the infarct-related artery has been related to improved in-hospital and late survival (24,25), recovery of left ventricular function (24,(26)(27)(28), prevention of ventricular aneurysm formation (29), and cardiac rupture (30), and enhanced electrical stability (31). In addition, previous studies have demonstrated that only the acute restoration of TIMI grade 3 flow, present in ≈50% to 60% of vessels after fibrinolysis, is independently predictive of in-hospital survival and reduction in infarct size (26,32,33).…”

Section: Discussionmentioning

confidence: 99%

Impact of a well-organized collaborative team approach on mortality in patients with ST-segment elevation myocardial infarction

Yaylali¹,

Susam²,

Ates³

et al. 2010

Anadolu Kardiyol Derg

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ÖZETAmaç: Bu çalışmanın amacı, etkin iyi planlanmış bir ekip yaklaşımının fibrinolitik tedavi almış akut ST-segment yükselmeli miyokart enfarktüslü (STEMİ) vakaların sağkalımına etkisini araştırmaktı. Yöntemler: Fibrinolitik tedavi akut STEMI'lı olgularda akılcı bir seçenek olmaya devam etmektedir. Fibrinolitik tedavi alan STEMI'lı olguların kısa sürede tedaviye ulaşmalarının mortalitelerini azalttığı defalarca gösterilmiştir. Nisan 2007'de iyi planlanmış bir ekip yaklaşımı başlatıldı. Sosyodemografik, klinik, laboratuvar ve zaman ölçümleri gibi bilgiler 109 çalışma hastasında prospektif olarak, 2005-2007 yıllarından 155 kontrol hastasında retrospektif olarak toplandı. Olguyu tartışmak için tek telefon konuşması yapıldı. Acil değerlendirme kesin olgularda yapılmadı. Şüpheli olgularda EKG'ler kardiyoloğa fakslandı. Kapı-iğne zamanları medyan olarak hesaplandı. Mortalite oranları kliniğe kontrole gelen hastalarda kayıtlar incelenerek, diğer tüm hastalarda telefon görüşmeleri ile belirlendi. Kapı-iğne zamanları Mann-Whitney U testi ile karşılaştırıldı. Altı aylık mortaliteler Fischer'in tam testi ile karşılaştırıldı. Bulgular: Çalışma grubunda kapı-iğne aralığı başvurma zamanından bağımsız anlamlı olarak azaldı (mesai dışında 59 dakikadan 29 dakikaya azaldı) (mesai içinde 35 dakikadan 18 dakikaya azaldı) (p<0.0001). Mortalite çalışma grubunda (2 ölüm, %1.8) kontrol grubu (12 ölüm, %7.7) ile karşılaştırıldığında anlamlı olarak azaldı (p=0.048). Sonuç: Akut ST yükselmeli miyokart enfarktüsü ile başvuran ve fibrinolitik tedavisi uygulanan hastaların ölüm oranları optimal hastane planlaması ile azalmıştır. (Anadolu Kardiyol Derg 2010 Aralık 1; 10(6): 508-13) Anahtar kelimeler: ST segment yükselmeli miyokart enfarktüsü, mortalite, iyi planlanmış ekip yaklaşımı ABSTRACT Objective: Fibrinolytic therapy remains a legitimate option for many patients presenting with acute ST-segment elevation myocardial infarction (STEMI). Shorter time-to-treatment for patients with STEMI administered fibrinolytic therapy has repeatedly been shown to reduce mortality. A well-organized collaborative team approach was implemented in April 2007. The purpose of this study was to examine the effect of implementing a well-organized collaborative team approach on the outcome in patients with acute STEMI treated with fibrinolysis. Methods: Sociodemographic, clinical, laboratory, and time interval data were prospectively collected on 109 consecutive patients (the study group) and 155 patients from the years 2005-2007 (the control group) retrospectively. A single-phone call was made to discuss case. Emergency department evaluation was bypassed for definitive case. An electrocardiogram was faxed to the on-call cardiologist for suspected case. Doorto-needle times were calculated as medians. Mortality was assessed by reviewing records of all patients visiting outpatient clinic. For the rest, information was obtained over the phone. Median door-to-needle times were compared using Mann-Whitney U test. The Fisher's exact test was used to compare 6-month mor...

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Early and late results of coronary angioplasty without antecedent thrombolytic therapy for acute myocardial infarction

Cited by 225 publications

References 33 publications

Outcomes of Primary Percutaneous Coronary Intervention in Acute Myocardial Infarction at Tehran Heart Center

Outcomes of Primary Percutaneous Coronary Intervention in Acute Myocardial Infarction at Tehran Heart Center

Risk Stratification After Acute Myocardial Infarction by Heart Rate Turbulence

Impact of a well-organized collaborative team approach on mortality in patients with ST-segment elevation myocardial infarction

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