Primary stent implantation is superior to balloon angioplasty in acute myocardial infarction: Final results of the primary angioplasty versus stent implantation in acute myocardial infarction (PASTA) trial

Saito, Shigeru; Hosokawa, George; Tanaka, Shinji; Nakamura, Shotaro

doi:10.1002/(sici)1522-726x(199911)48:3<262::aid-ccd5>3.3.co;2-w

Cited by 28 publications

(47 citation statements)

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“…Some observations of the CENIC registry reproduced the findings of several randomized studies [11][12][13][14][15][16][17] . Since 1996, 5 multicenter studies have been conducted that randomized approximately 1,400 patients for stenting or balloon use in 17 studies showed similar conclusions.…”

Section: Discussionsupporting

confidence: 70%

“…Since 1996, 5 multicenter studies have been conducted that randomized approximately 1,400 patients for stenting or balloon use in 17 studies showed similar conclusions. The in-hospital results of these studies showed no significant differences in regard to reduction in the occurrence of major events (reinfarction, stroke and death) and in regard to the success of the procedure.…”

Section: Discussionmentioning

confidence: 87%

“…These studies aim to assess the immediate safety of the method and its late efficacy [11][12][13][14][15][16][17] .…”

Section: Discussionmentioning

confidence: 99%

“…So, in 3,924 patients we could detect the significant exponential growth of stent implantation in acute myocardial infarction, which accounted for 20% of the procedures in 1996 and increased to 49% in 1998. This significant change is related to the daily evidence of good results obtained with stenting and the progressive publication of the randomized series [11][12][13][14][15][16][17] , therefore justifying the increased use of stents.…”

Section: Discussionmentioning

confidence: 99%

“…Coronary stent implantation in acute myocardial infarction is a recent therapeutical option aiming to optimize immediate and late results [11][12][13][14][15][16][17] , based on evidence observed in elective patients 18,19 .…”

Section: Primary Coronary Angioplasty and Stent Implantation In Acutementioning

confidence: 99%

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Primary coronary angioplasty and stent implantation in acute myocardial infarction. Comparative analysis of the in-hospital results in the CENIC/SBHCI registry

Mattos¹,

Sousa²,

Neto³

et al. 1999

Arq. Bras. Cardiol.

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Objective -Comparative analysis of the in-hospital results after primary implantation of stents or coronary balloon angioplasty in patients with acute myocardial infarction (MI). Methods -CENIC (National Center of Cardiovascular Interventions) gathered data on 3,924 patients undergoing coronary angioplasty (in the primary form, without the previous use of thrombolytic agents) in the first 24 hours after a MI, during the period of 1996 (6.3% vs. 4.5%, p=0.01), anterior MI and stent implantation in left descending artery (55% vs. 48% vs. p=0.009), and saphenous vein bypass grafts (3.3% vs. 1.9%). the procedure was more succesful in the group of stents (97% vs. 84%, p=0.001) and reinfarction rate (2.5 vs. 4%, p=0.002). The need for emergency revascularization was similar (1% vs. 1.1%, NS). Total in-hospital mortality was lower in stent group (3.4% vs. 7. 2%, p=0.0001) Primary coronary angioplasty is one of the preferred methods of myocardial reperfusion performed without previous use of thrombolytic agents for the treatment of acute myocardial infarction [1][2][3][4][5] . It provides high levels of immediate arterial permeability with TIMI 3 optimal coronary flow 6 . When available, it is comprehensive and offers a significant reduction in the occurrence of major immediate events, such as reinfarction, stroke, and death 3,5 .Results of randomized studies 7,8 , registries 9 , and consecutive series 10 , however, with the application of primary coronary angioplasty in acute myocardial infarction showed loss of immediate and late results in some subgroups of patients. In the in-hospital phase, the number of recurrent ischemias and reinfarctions was higher when suboptimal results were present (residual stenosis >30% and significant coronary dissection); at 6 months, restenosis and reocclusion of the vessel initially treated were as high as 45% and, in 25% of the cases, new myocardial revascularization procedures were performed , 9,10 .Coronary stent implantation in acute myocardial infarction is a recent therapeutical option aiming to optimize immediate and late results [11][12][13][14][15][16][17] , based on evidence observed in elective patients 18,19 .Our aim was to assess the in-hospital results of two techniques of percutaneous coronary revascularization in the acute phase of myocardial infarction: primary coronary stent implantation and conventional primary coronary balloon angioplasty. These two techniques are part of the national registry of procedures, CENIC (National Center of Cardiovascular Interventions), which belongs to the Sociedade Brasileira de Hemodinâmica e Cardiologia Intervencionista -SBHCI

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Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 87%

“…These studies aim to assess the immediate safety of the method and its late efficacy [11][12][13][14][15][16][17] .…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Primary Coronary Angioplasty and Stent Implantation In Acutementioning

confidence: 99%

See 3 more Smart Citations

Primary coronary angioplasty and stent implantation in acute myocardial infarction. Comparative analysis of the in-hospital results in the CENIC/SBHCI registry

Mattos¹,

Sousa²,

Neto³

et al. 1999

Arq. Bras. Cardiol.

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PASTA is good, but SUSHI is better

Cheng

2000

Cathet. Cardiovasc. Intervent.

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Primary stenting in nonselected patients with acute myocardial infarction: The Multilink Duet in Acute Myocardial Infarction (MIAMI) trial

Antoniucci

Valenti

Moschi

et al. 2000

Cathet. Cardiovasc. Intervent.

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Most randomized trials comparing primary stenting with primary coronary angioplasty (PTCA) excluded patients at high risk from enrollment, thus arising the important question about the generalizability of the randomized trial results to all patients with AMI. The aim of this study was to assess the feasibility and effectiveness of a primary infarct-related artery (IRA) stenting strategy using a second-generation tubular stent in nonselected patients with acute myocardial infarction (AMI). All patients with AMI were considered eligible for primary IRA stenting. No restriction was made based on age or clinical status on presentation, or coronary anatomy, except in cases of a reference IRA diameter < 2.5 mm. The primary endpoint of the study was clinical target vessel failure defined as death, reinfarction, or repeat TVR due to restenosis or reocclusion of the IRA. Between June 1998 and March 1999, 201 consecutive patients with AMI underwent mechanical recanalization of the IRA. The mean age was 64 +/- 12, and 16% of patients were aged 75 years or over. The incidence of shock was 9%. Primary IRA stenting was performed in 89% of the patients. Patients who underwent PTCA alone had a smaller IRA diameter as compared to patients with a stented IRA (2.48 +/- 0.46 mm vs. 3.15 +/- 0.37 mm; P < 0.001). There were no stent deployment failures. The 6-month primary endpoint rate was 15% (2 deaths, 27 repeat TVR, 0 reinfarctions), while the 6-month angiographic restenosis rate was 22%. Primary IRA stenting in nonselected patients with AMI is highly feasible and associated with favorable clinical and angiographic outcomes. Cathet. Cardiovasc. Intervent. 51:273-279, 2000.

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Primary stent implantation is superior to balloon angioplasty in acute myocardial infarction: Final results of the primary angioplasty versus stent implantation in acute myocardial infarction (PASTA) trial

Cited by 28 publications

References 0 publications

Primary coronary angioplasty and stent implantation in acute myocardial infarction. Comparative analysis of the in-hospital results in the CENIC/SBHCI registry

Primary coronary angioplasty and stent implantation in acute myocardial infarction. Comparative analysis of the in-hospital results in the CENIC/SBHCI registry

PASTA is good, but SUSHI is better

Primary stenting in nonselected patients with acute myocardial infarction: The Multilink Duet in Acute Myocardial Infarction (MIAMI) trial

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