Revascularization after thrombolytic therapy for acute myocardial infarction: an analysis of 573 patients.
Ann Thorac Surg
; 46(2): 163-6, 1988 Aug.
Article
en En
| MEDLINE
| ID: mdl-2969705
ABSTRACT
From October, 1981, to January, 1987, at our center, 891 patients received streptokinase within 6 hours of acute myocardial infarction. A total of 318 patients were treated medically, while 388 patients (43.5%) underwent coronary artery bypass grafting (CABG) alone and 185 (20.7%) were treated with percutaneous coronary angioplasty (PTCA). Subsequent CABG was performed in 37 of 185 PTCA patients after unsuccessful angioplasty. Group characteristics were similar. However, multiple-vessel coronary artery disease was present in 70.3% of CABG patients compared with 24.1% in the PTCA groups. Procedure mortality was 3.6% for CABG alone, 5.4% for PTCA alone, and 13.5% for the combined angioplasty and operation group (p less than 0.05 compared with CABG). All deaths in the PTCA group with subsequent CABG occurred in those patients taken emergently to CABG (5 of 20 patients). We conclude that with proper patient selection both forms of revascularization are safe and effective. However, emergency coronary bypass surgery in the event of failed angioplasty has a high risk.
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Banco de datos:
MEDLINE
Asunto principal:
Estreptoquinasa
/
Puente de Arteria Coronaria
/
Angioplastia de Balón
/
Infarto del Miocardio
Tipo de estudio:
Etiology_studies
/
Risk_factors_studies
Límite:
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Año:
1988
Tipo del documento:
Article