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Results of primary percutaneous coronary intervention in a consecutive group of patients with acute ST elevation myocardial infarction at a tertiary Australian centre.
van Gaal, W J; Clark, D; Barlis, P; Lim, C C S; Johns, J; Horrigan, M.
Afiliação
  • van Gaal WJ; Department of Cardiology, The John Radcliffe, Oxford, United Kingdom. bill.vangaal@conted.ox.ac.uk
Intern Med J ; 37(7): 464-71, 2007 Jul.
Article em En | MEDLINE | ID: mdl-17445011
BACKGROUND: Multicentre randomized controlled trials (RCT) of primary percutaneous coronary intervention (PCI) for ST elevation myocardial infarction (STEMI) have consistently shown lower mortality compared with fibrinolysis, if carried out in a timely manner. Although primary PCI is now standard of care in many centres, it remains unknown whether results from RCT of selected patients are generalizable to a 'real-world' Australian setting. The primary goal of this study was to evaluate whether a strategy of routine invasive management for patients with STEMI can achieve 30-day and 12-month mortality rates comparable with multicentre RCT. Secondary goals were to determine 30-day mortality rates in prespecified high-risk subgroups, and symptom-onset- and door-to-balloon-inflation times. METHODS: A retrospective observational study of 189 consecutive patients treated with primary PCI for STEMI in a single Australian centre performing PCI for acute STEMI. RESULTS: All-cause mortality was 6.9% at 30 days, and 10.4% at 12 months. Mortality in patients presenting without cardiogenic shock was low (2.4% at 30 days; 5.0% at 12 months), whereas 12-month mortality in patients with shock was higher, particularly in the elderly (29.4% for patients <75 years; 85.7% for patients > or =75 years, P = 0.01). Symptom-onset-to-balloon-inflation time was < or =4 h in 56% of patients (median 231 min); however, a door-to-balloon time of <90 min was achieved in only 20% (median 133 min). CONCLUSION: Mortality and symptom-onset-to-balloon-inflation times reported in RCT of primary PCI for STEMI are generalizable to 'real-world' Australian practice; however, further efforts to reduce door-to-balloon times are required.
Assuntos
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Eixos temáticos: Pesquisa_clinica Base de dados: MEDLINE Assunto principal: Angioplastia Coronária com Balão / Terapia Trombolítica / Infarto do Miocárdio Tipo de estudo: Clinical_trials / Diagnostic_studies / Observational_studies Limite: Aged / Female / Humans / Male / Middle aged País como assunto: Oceania Idioma: En Ano de publicação: 2007 Tipo de documento: Article
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Eixos temáticos: Pesquisa_clinica Base de dados: MEDLINE Assunto principal: Angioplastia Coronária com Balão / Terapia Trombolítica / Infarto do Miocárdio Tipo de estudo: Clinical_trials / Diagnostic_studies / Observational_studies Limite: Aged / Female / Humans / Male / Middle aged País como assunto: Oceania Idioma: En Ano de publicação: 2007 Tipo de documento: Article