Primary stent implantation without coumadin in acute myocardial infarction

Saïto, Shigeru; Hosokawa, George; Kim, Kunikane; Tanaka, Shinji; Miyake, Shogo

doi:10.1016/0735-1097(96)00125-8

Cited by 100 publications

(41 citation statements)

References 22 publications

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“…5,6 Recently, coronary stenting has become a safe choice of treatment for patients with AMI and has improved its outcome. 7,8 The present study investigated how the treatment and outcome of AMI have changed in clinical practice. Hiroshima City Hospital is a community hospital located in the center of Hiroshima City and currently has a 10-bed coronary care unit and an additional 41 beds for the Department of Cardiology.…”

Section: Discussionmentioning

confidence: 99%

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Fifteen-Year Trend in the Treatment and Outcome of Acute Myocardial Infarction in Japan

Ishihara

Inoue

Kawagoe

et al. 2002

Circ J

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Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8] Previous studies, however, have been investigated in patients selected as suitable for the procedures, and little is known about outcomes in the 'real world'. This study assessed the changes in treatment and outcome of AMI during the past 15 years at Hiroshima City Hospital.…”

mentioning

confidence: 99%

Fifteen-Year Trend in the Treatment and Outcome of Acute Myocardial Infarction in Japan

Ishihara

Inoue

Kawagoe

et al. 2002

Circ J

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“…Em seus resultados preliminares, a mortalidade foi de 0,8%, reinfarto 1,7%, isquemia recorrente 3,8% e necessidade de reintervenção, 2,1% 91 . Saito e col também publicaram um trabalho comparando ATC e stent em IAM que evidencia eventos clínicos maiores durante a fase hospitalar em 18,6% x 2,8% 92 , respectivamente. Pela escassez de dados, no entanto, o consenso do ACC não traça conclusões sobre o valor do stent nesta situação clínica 5 .…”

Section: Arq Bras Cardiol Volume 71 (Nº 1) 1998unclassified

Stents. Uma revisão da literatura

Guérios

Bueno

Andrade

et al. 1998

Arq. Bras. Cardiol.

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Revisão Aspectos históricosCharles Stent foi um dentista inglês que há mais de um século idealizou um material dentário para moldagem. Mais tarde, este material foi utilizado como suporte para tecidos vivos em cicatrização 1 . Em 1964, Dotter e Judkins descreveram o procedimento original de angioplastia com o uso de cateter de dilatação em circulação periférica, antevendo sua aplicabilidade em circulação coronária 2 . Para combater o alto índice de reestenose que se seguia à angioplastia, foi proposto também por Dotter, em 1969, o implante de uma prótese endovascular que promovesse sustentação da parede do vaso após a intervenção. Por semelhança, esta prótese recebeu o nome de stent. Em sua experiência inicial usando enxertos tubulares plásticos, houve trombose de todos eles em 24h. Contudo, os resultados melhoraram quando se usaram molas de aço inoxidável 3 . Apesar do entusiasmo de Dotter, a técnica de dilatação transluminal percutânea de obstruções vasculares não obteve repercussão nos Estados Unidos. Foi, entretanto, empregada e modificada em vários centros europeus. Andreas Grüntzig, na Suíça, desenvolveu um cateter de dilatação com dupla luz e um balão não-elástico, usando-os com sucesso em artérias femorais e poplíteas. Estendeu então o seu uso para artérias coronárias, em 1977 4 , o que impulsionou a cardiologia invasiva diagnóstica para a era do intervencionismo. A partir de então, tem se observado rápi-do crescimento tecnológico e constante aperfeiçoamento neste campo. Atualmente, mais de 400 mil norte-americanos e quase 900 mil pacientes em todo o mundo são submetidos à angioplastia transluminal coronária (ATC) a cada ano 5,6 . Foram desenvolvidos métodos alternativos e/ou complementares à técnica tradicional, como a aterectomia (direcional, rotacional e por laser) e a abordagem farmacológica (antagonistas da serotonina, inibidores da enzima de conversão da angiotensina, estimuladores da liberação de óxi-do nítrico, anticorpos anti-glicoproteína IIB/IIIA, entre outros) 7 . Avançou-se no entendimento da doença aterosclerótica e dos efeitos da ATC sobre ela com o advento da angioscopia e do ultra-som intravascular.

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“…[8][9][10] These findings appear to result from the significantly larger mean minimal luminal diameter (MLD) obtained after coronary arterial stenting than that obtained with POBA alone, and favorable (thrombolysis in myocardial infarction; TIMI grade 3) coronary arterial blood flow during reperfusion therapy. 1,2,4,5,7,11,12) When a sufficient MLD of the infarct-related artery is secured after the recovery of TIMI grade 3 flow by POBA alone, the issue of whether the concomitant use of coronary arterial stenting contributes to the improvement of left ventricular overloading during the chronic stage is currently unclear.…”

mentioning

confidence: 99%

<b>Does Coronary Artery Stenting for Acute Myocardial Infarction Improve Left Ventricular Overloading at the Chronic Stage?</b>

et al. 2004

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SUMMARYIn the present study, we evaluated whether stenting is useful for cardiac overloading, using ANP, BNP, and 99m Tc-tetrofosmin myocardial scintigraphy. It has been reported that coronary artery stenting is useful for cardiac functions for acute myocardial infarction (AMI). The subjects were 110 patients with AMI successfully treated by direct angioplasty. These patients were subgrouped into two groups: the S group (underwent stenting; 54 patients) and the P group (underwent POBA alone; 56 patients). Extent scores reflecting decreased myocardial blood flow were calculated at myocardial areas showing a radioactivity count of less than -2 × standard deviations compared to the database of normal subjects.The ratio of extent scores to defect scores (extent/defect ratio) was compared between the P and S groups. Both ANP and BNP levels in the S group were lower than in the P group at the chronic stage (1 and 3 months after reperfusion therapy). Moreover, the end-diastolic volume index from the left ventriculography 3 months after reperfusion therapy was significantly larger in the P than the S group. The extent/defect ratio was significantly lower in the P group (2.8 ± 0.2) than the S group (3.5 ± 0.3), suggestive of a microcirculation disorder. These results suggest that cardiac overloading and left ventricular remodeling are decreased more by stenting than by POBA alone, probably because stenting prevents decreased myocardial blood flow around the infarct myocardium. (Jpn Heart J 2004; 45: 217-229)

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Primary stent implantation without coumadin in acute myocardial infarction

Abstract: Primary stent implantation can improve clinical outcomes of patients with acute myocardial infarction when the stent is dilated adequately and antiplatelet drugs are used.

Cited by 100 publications

References 22 publications

Fifteen-Year Trend in the Treatment and Outcome of Acute Myocardial Infarction in Japan

Fifteen-Year Trend in the Treatment and Outcome of Acute Myocardial Infarction in Japan

Stents. Uma revisão da literatura

<b>Does Coronary Artery Stenting for Acute Myocardial Infarction Improve Left Ventricular Overloading at the Chronic Stage?</b>

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