Coronary Angioplasty with or without Stent Implantation for Acute Myocardial Infarction

Grines, Cindy L.; Cox, David A.; Stone, Gregg W.; Garcı́a, Eulogio; Mattos, Luiz Alberto; Giambartolomei, Alessandro; Brodie, Bruce R.; Madonna, O.; Eijgelshoven, M. H. J.; Lansky, Alexandra J.; O’Neill, William W.; Morice, Marie‐Claude

doi:10.1056/nejm199912233412601

Cited by 849 publications

(347 citation statements)

References 23 publications

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“…Stenting in AMI has been associated with less slow-flow, better ST segment resolution and improved procedural and clinical outcomes [1,2,3]. Therefore, we performed stenting to all our patients.…”

Section: Discussionmentioning

confidence: 99%

“…Studies comparing primary angioplasty with primary stenting for acute myocardial infarction (AMI) have shown that primary stenting improved the procedural success rate and clinical outcome [1,2,3]. GpIIb/IIIa inhibitors combined with primary stenting have improved both epicardial [4] and microvascular flow [5] and led to a greater extent of myocardial salvage in patients with AMI [6].…”

Section: Introductionmentioning

confidence: 99%

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Impact of Early Tirofiban Administration on Myocardial Salvage in Patients with Acute Myocardial Infarction Undergoing Infarct-Related Artery Stenting

Emre¹,

Ücer²,

Yeşilçimen³

et al. 2006

Cardiology

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Background/Aims: The timing of GpIIb/IIIa inhibitor administration may be important in achieving early epicardial and myocardial reperfusion. We evaluated the effect of early tirofiban on myocardial salvage and cardiovascular outcome in patients with acute myocardial infarction (AMI) undergoing infarct-related artery stenting. Methods: Patients (n = 66) with a first AMI presenting <6 h from onset of symptoms were randomized to either early administration of tirofiban in the emergency room (n = 32) or later administration in the catheterization laboratory (n = 34) (tirofiban bolus dose of 10 µg/kg, followed by 0.15 µg/kg for 24 h). The primary end-point was the degree of myocardial salvage, determined by means of serial scintigraphic studies with technetium-99m sestamibi. Thirty-day major adverse cardiac events were also assessed. Results: There were no significant differences in patient characteristics or in their presentation. The mean door-to-balloon time was similar in both groups (43 ± 12 and 53 ± 9 min, p = 0.08). The early and late treatment groups received tirofiban 18 ± 4 and 52 ± 10 min after admission, respectively. Angiographic analysis revealed a higher initial frequency of TIMI grade 3 flow in the early group (31% vs. 12%, p = 0.04). Procedural success was achieved in all patients. Myocardial risk area were comparable between early and late treatment groups (35.6 ± 12.2% vs. 39.3 ± 14.0%, p = 0.6). Scintigraphic outcomes demonstrated a significant reduction in the final infarction size (11.8 ± 5.2% vs. 22.4 ± 6.2%, p = 0.01), and improvement in salvage index (0.68 ± 0.22 vs. 0.44 ± 0.18, p = 0.003) in favor of the early tirofiban group. The thirty-day composite end-point of death, recurrent MI or rehospitalization also favored the early group (6% early, 15% late, p = 0.06). Conclusion: Early tirofiban administration enhanced the degree of myocardial salvage and clinical outcome in patients with AMI undergoing infarct-related artery stenting.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Impact of Early Tirofiban Administration on Myocardial Salvage in Patients with Acute Myocardial Infarction Undergoing Infarct-Related Artery Stenting

Emre¹,

Ücer²,

Yeşilçimen³

et al. 2006

Cardiology

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“…Vascular complications and the need for blood transfusions occur more frequently in women, even when weight-adjusted antithrombin agents are used, 229,230 and female sex remains an independent predictor of bleeding. 231 Although early-generation stenting was associated with higher mortality in women, 232 later studies found that bare metal stenting during primary PCI compared with angioplasty in women reduced MACE rates and target vessel revascularization, without influencing death or reinfarction rates. 229 A patient-level pooled analysis comparing stent choice in women found that newer-generation drug eluting stents (DES) were associated with reduced death or MI and reduced target vessel revascularization compared with both early-generation DES and bare metal stents; however, these data were not exclusively from STEMI patients.…”

Section: Primary Pcimentioning

confidence: 99%

Acute Myocardial Infarction in Women

Mehta¹,

Beckie²,

DeVon³

et al. 2016

Circulation

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910

393

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Cardiovascular disease is the leading cause of mortality in American women. Since 1984, the annual cardiovascular disease mortality rate has remained greater for women than men; however, over the last decade, there have been marked reductions in cardiovascular disease mortality in women. The dramatic decline in mortality rates for women is attributed partly to an increase in awareness, a greater focus on women and cardiovascular disease risk, and the increased application of evidence-based treatments for established coronary heart disease. This is the first scientific statement from the American Heart Association on acute myocardial infarction in women. Sex-specific differences exist in the presentation, pathophysiological mechanisms, and outcomes in patients with acute myocardial infarction. This statement provides a comprehensive review of the current evidence of the clinical presentation, pathophysiology, treatment, and outcomes of women with acute myocardial infarction.

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“…One is the chronic phase, with significant stenosis in a coronary artery and clinically stable or unstable angina, and the other is the case of acute occlusion of a coronary artery with threatening or manifest myocardial infarction. These situations are often investigated by and treated with coronary angiography followed by various interventional procedures (1,3,4).…”

mentioning

confidence: 99%

Evaluation of nonperfused myocardial ischemia with MRI and an intravascular USPIO contrast agent in an ex vivo pig model

Bjerner

Ericsson

Wikström

et al. 2000

J. Magn. Reson. Imaging

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Coronary Angioplasty with or without Stent Implantation for Acute Myocardial Infarction

Abstract: In patients with acute myocardial infarction, routine implantation of a stent has clinical benefits beyond those of primary coronary angioplasty alone.

Cited by 849 publications

References 23 publications

Impact of Early Tirofiban Administration on Myocardial Salvage in Patients with Acute Myocardial Infarction Undergoing Infarct-Related Artery Stenting

Impact of Early Tirofiban Administration on Myocardial Salvage in Patients with Acute Myocardial Infarction Undergoing Infarct-Related Artery Stenting

Acute Myocardial Infarction in Women

Evaluation of nonperfused myocardial ischemia with MRI and an intravascular USPIO contrast agent in an ex vivo pig model

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