Primary coronary angioplasty for acute myocardial infarction (the primary angioplasty registry)

ACC/AHA/SCAI Practice Guidelines, February 21, 2006

“…Subsequent studies of PCI continue to identify annual procedural volume both at the program level and at the operator level as strongly correlated with complication rates. Most studies' findings are consistent with the operator threshold of 75 procedures per year (47,306,309,(314)(315)(316)(317)(318)(319)(320).…”

Effectiveness of primary angioplasty in the treatment of acute myocardial infarction. Analysis of in-hospital and late outcomes in 135 consecutive cases

“…The in-hospital mortality of 18.5% and the angiographic success of 78% are not in total accordance with the results reported in the literature, which range from 0% to 10% and from 73% to 98%, respectively [24][25][26][27][28][29]35,[37][38][39]41 . However, we should consider that this cohort assesses the patients in a global manner, without excluding the most severely ill ones with Killip III and IV functional classes, and that it uses a very strict criterion for the definition of success of a procedure, which is exclusively the obtainment of TIMI 3 flow, with residual stenosis lower than 50% in patients surviving an event.…”

“…On the other hand, in regard to the previous pathological history, hypertension, tobacco use, diabetes mellitus, dyslipidemia, previous infarction, and obesity, these data are largely variable when compared with those of other series 28,35,38 . This may be due to the fact that this was a heterogeneous nonrandomized population, and, therefore, not reliably representing all those patients with acute myocardial infarction.…”

“…The result is a decrease in the area of infarct, and improvement in the ventricular function, which leads to better indices of survival and reduced morbidity and mortality [3][4][5][6][7][8][9][10][11][12][13][14][15][16] . Other randomized and nonrandomized clinical trials have suggested that primary angioplasty may result in a higher rate of coronary reperfusion and patency, a lower index of reoclusion and of systemic bleedings, a shorter time of hospitalization, and a reduction in hospital costs; on the other hand, other studies have shown no significant difference [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] . However, primary angioplasty is well known to be of difficult and limited applicability in our environment, because of our geographical, political, and, mainly, economic situation, which limits the access to the procedure to a small part of the population.…”

Does Coronary Stenting Affect Microvascular Circulation in Patients With Anterior Acute Myocardial Infarction? Comparison With Balloon Angioplasty.

“…1,2 However, despite successful revascularization, a substantial number of patients still fail to obtain complete and sustained myocardial reperfusion and remain at risk of developing large infarcts. There is concern that there is a discrepancy between an open epicardial infarct-related coronary artery and blood flow in the impaired distal microvascular circulation.…”