| 1. |
|
|
| 2. |
|
|
| 3. |
|
|
| 4. |
|
|
| 5. |
- Herlitz, Johan, et al.
(författare)
-
Characteristics and outcome of patients with ST-elevation infarction in relation to whether they received thrombolysis or underwent acute coronary angiography : are we selecting the right patients for coronary angiography?
- 2003
-
Ingår i: Clinical Cardiology. - : John Wiley & Sons, Inc.. - 0160-9289 .- 1932-8737. ; 26:2, s. 78-84
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: During the last decade, there has been an on-going debate with regard to whether percutaneous coronary intervention (PCI) or thrombolysis should be preferred in patients with ST-elevation acute myocardial infarction (AMI). Some studies clearly advocate PCI, while others do not. HYPOTHESIS: The study aimed to describe the characteristics and to evaluate outcome of patients with suspected ST-elevation or left bundle-branch block infarction in relation to whether they received thrombolysis or had an acute coronary angiography aiming at angioplasty. METHODS: The study included all patients admitted to Sahlgrenska University Hospital in Göteborg, Sweden, with suspected acute myocardial infarction who, during 1995-1999, had ST-elevation or left bundle-branch block on admission electrocardiogram (ECG) requiring either thrombolysis or acute coronary angiography. A retrospective evaluation with a follow-up of 1 year after the intervention was made. RESULTS: In all, 413 patients had thrombolytic treatment and 400 had acute coronary angiography. The patients who received thrombolysis were older (mean age 70.3 vs. 64.1 years). Mortality during 1 year of follow-up was 20.9% in the thrombolysis group and 16.6% in the angiography group (p = 0.12). Among patients in whom acute coronary angiography was performed, only 85% underwent acute percutaneous coronary intervention (PCI). There was a mortality of 12.1 vs. 41.7% among those who did not undergo acute PCI. Development of reinfarction, stroke, and requirement of rehospitalization was similar regardless of type of initial intervention. The thrombolysis group more frequently required new coronary angiography (36.9 vs. 20.6%; p<0.0001) and new PCI (17.8 vs. 11.9%; p = 0.01). Despite this, after 1 year symptoms of angina pectoris were observed in 27% of patients in the thrombolysis group and in only 14% of those in the angiography group (p = 0.0002). CONCLUSION: In a Swedish university hospital with a high volume of coronary angioplasty procedures, we found no significant difference in mortality between patients who had thrombolysis and those who underwent acute coronary angiography. However, requirement of revascularization and symptoms of angina pectoris 1 year later was considerably less frequent in those who had undergone acute coronary angiography. However, distribution of baseline characteristics was skewed and efforts should be focused on the selection of patients for the different reperfusion strategies.
|
|
| 6. |
|
|
| 7. |
- Svensson, L, et al.
(författare)
-
Predictors of myocardial damage prior to hospital admission among patients with acute chest pain or other symptoms raising a suspicion of acute coronary syndrome.
- 2003
-
Ingår i: Coronary Artery Disease. - : Lippincott Williams & Wilkins. - 0954-6928 .- 1473-5830. ; 14:3, s. 225-231
-
Tidskriftsartikel (refereegranskat)abstract
- AIM: To evaluate factors which, prior to hospital admission, predict the development of acute coronary syndrome or acute myocardial infarction among patients who call for an ambulance due to suspected acute coronary syndrome. DESIGN: Prospective observational study. METHODS: All the patients who called for an ambulance due to suspected acute coronary syndrome in South Hospital's catchment area in Stockholm and in the Municipality of Göteborg between January and November 2000, were included. On arrival of the ambulance crew, a blood sample was drawn for bedside analysis of serum myoglobin, creatine kinase (CK)MB and troponin-I. A 12-lead electrocardiogram (ECG) was simultaneously recorded. RESULTS: In all, 538 patients took part in the survey. Their mean age was 69 years and 58% were men. In all, 307 patients (57.3%) had acute coronary syndrome and 158 (29.5%) had acute myocardial infarction. Independent predictors of the development of acute coronary syndrome were a history of myocardial infarction (P=0.006), angina pectoris (P=0.005) or hypertension (P=0.017), ECG changes with ST elevation (P<0.0001), ST depression (P<0.0001) or T-wave inversion (P=0.012) and the elevation of CKMB (P=0.005). Predictors of acute myocardial infarction were being a man (P=0.011), ECG changes with ST elevation (P<0.0001) or ST depression (P<0.0001), the elevation of CKMB (P<0.0001) and a short interval between the onset of symptoms and blood sampling (P=0.010). CONCLUSION: Among patients transported by ambulance due to suspected acute coronary syndrome, predictors of myocardial damage can be defined prior to hospital admission on the basis of previous history, sex, ECG changes, the elevation of biochemical markers and the interval from the onset of symptoms until the ambulance reaches the patient.
|
|
| 8. |
|
|
| 9. |
|
|
| 10. |
- Bräutigam, Malin, et al.
(författare)
-
[Primary PTCA or thrombolysis in acute myocardial infarction?]. : Primär PTCA eller trombolys vid akut hjärtinfarkt?
- 2001
-
Ingår i: Läkartidningen. - 0023-7205. ; 98:32-33, s. 3392-5
-
Tidskriftsartikel (refereegranskat)abstract
- In acute ST-elevation infarction two different reperfusion strategies--thrombolytic medication and acute coronary angiography--have proved to improve the prognosis. The clinical course for patients with ST-elevation infarction is described in relation to whether they received thrombolytic medication or underwent acute coronary angiography with the aim of mechanical revascularization. The one-year mortality was high (20 percent) regardless of treatment strategy. In terms of morbidity there were no clear differences between the two treatment groups.
|
|
