In-Hospital and Late Results of Coronary Stents Versus Conventional Balloon Angioplasty in Acute Myocardial Infarction (GRAMI trial)

Rodríguez, Alfredo E.; Bernardi, Víctor; Fernandez, Mario Aguilar; Mauvecin, Carlos; Ayala, Francisco J.; Santaera, Omar; Martı́nez, Jorge; Mele, Eduardo; Gs, Roubin; Palacios, Igor F.; Ambrose, J. A.

doi:10.1016/s0002-9149(98)00154-4

Cited by 154 publications

(71 citation statements)

References 25 publications

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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: 67%

“…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%

“…Success of coronary angioplasty was higher because of the possibility of stent implantation in the event of a poor initial outcome. This crossover between treatments was approximately 20% [13][14][15][16] . The immediate mortality rates reported in these studies were in accordance with those observed in our registry.…”

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: 67%

“…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: 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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Coronary Artery Stents

Suwaidi¹

2000

JAMA

186

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Contribution of stenting to the results of rescue PTCA

Cafri

Denktaş

Crystal

et al. 1999

Cathet. Cardiovasc. Intervent.

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Failed thrombolysis in acute myocardial infarction (AMI) is associated with increased mortality. Controversial benefit of rescue percutaneous transluminal coronary angioplasty (PTCA) in these setting has been published. The feasibility, safety, and contribution of stenting to the outcome of AMI patients treated with this strategy is unknown. We studied the angiographic result and clinical outcome of 33 patients with failed thrombolysis referred for rescue angioplasty. Twenty‐three patients had stenting and 10 patients did not have stenting. Both groups had similar clinical and angiographic characteristics. Stent indications were nonoptimal result, 40%; bailout, 40%; elective, 20%. Angiographic success was 100% with stent vs. 91% with balloon alone (P < 0.8). Postprocedure residual stenosis was 1.5% (0%–10%) with stent vs. 18.05% (0%–30%) with balloon alone (P < 0.01). Thirty‐day outcome with and without stent was mortality, 0% vs. 13% (P < 1.0); reinfarction, 10% vs. 0% (P < 0.30); target vessel revascularization, 0% vs. 21% (P < 0.21). The 6‐month mortality was 0% with stent vs. 14% (P < 0.5). We conclude that stenting during rescue angioplasty is feasible, safe, and is associated with better immediate angiographic results. Although no obvious clinical benefit was found, a potential decrease in the revascularization rate was suggested. Cathet. Cardiovasc. Intervent. 47:411–414, 1999. © 1999 Wiley‐Liss, Inc.

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In-Hospital and Late Results of Coronary Stents Versus Conventional Balloon Angioplasty in Acute Myocardial Infarction (GRAMI trial)

Cited by 154 publications

References 25 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

Coronary Artery Stents

Contribution of stenting to the results of rescue PTCA

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