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Comparison of very ...
Comparison of very early treatment with either fibrinolysis or percutaneous coronary intervention facilitated with abciximab with respect to ST recovery and infarct-related artery epicardial flow in patients with acute ST-segment elevation myocardial infarction: the Swedish Early Decision (SWEDES) reperfusion trial
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- Svensson, L. (författare)
- Karolinska Institutet
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- Aasa, M. (författare)
- Karolinska Institutet
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- Dellborg, Mikael, 1954 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för akut och kardiovaskulär medicin,Institute of Medicine, Department of Emergeny and Cardiovascular Medicine
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Gibson, C. M. (författare)
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Kirtane, A. (författare)
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- Herlitz, Johan, 1949 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine,[external]
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Ohlsson, A. (författare)
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- Karlsson, Thomas, 1956 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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- Grip, Lars, 1952 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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(creator_code:org_t)
- Mosby, Inc. 2006
- 2006
- Engelska.
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Ingår i: Am Heart J. - : Mosby, Inc.. - 1097-6744 .- 0002-8703. ; 151:4
- Relaterad länk:
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https://gup.ub.gu.se...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- BACKGROUND: Results from a number of studies indicate that primary percutaneous coronary intervention (PCI) is superior to fibrinolysis for treatment of acute ST-elevation myocardial infarction. Modern adjunctive antithrombotic treatment with systematic use of low-molecular-weight heparins, fibrin-specific thrombolysis, and glycoprotein IIb/IIIa receptor inhibitors may improve the outcome compared with what was achieved in previous studies. METHODS: Patients with ST-elevation myocardial infarction were randomized to receive enoxaparin followed by reteplase (group A; n = 104) or enoxaparin followed by abciximab and transfer to invasive center for optional PCI (group B; n = 101). Primary end points were ST-segment resolution 120 minutes and TIMI flow at coronary angiography 5 to 7 days after randomization. RESULTS: Forty-two percent of the patients started therapy in the prehospital phase. Time from symptom to treatment was 114 minutes in group A and 202 minutes in group B. Baseline characteristics were similar in the 2 groups. Sixty-four percent in group A and 68% in group B had ST resolution of > 50% at 120 minutes (not significant). At control angiography, 54% in the fibrinolytic group and 71% in the invasive group had TIMI 3 flow (P = .04). At 30 days, the composite of death, stroke, or reinfarction occurred in 8% in the fibrinolytic group compared with 3% in the invasive group (not significant). CONCLUSIONS: Despite much shorter time delay to start of fibrinolysis than PCI, this did not result in signs of superior myocardial reperfusion. Epicardial flow in the infarct-related artery was better after invasive therapy, and there was a trend toward better clinical outcome after this treatment compared with after fibrinolysis.
Nyckelord
- Adult
- Aged
- *Angioplasty
- Transluminal
- Percutaneous Coronary
- Antibodies
- Monoclonal/*therapeutic use
- Antifibrinolytic Agents/*therapeutic use
- Coronary Angiography
- Enoxaparin/*therapeutic use
- Female
- Humans
- Immunoglobulin Fab Fragments/*therapeutic use
- Male
- Middle Aged
- Myocardial Infarction/*drug therapy/radiography
- Platelet Glycoprotein GPIIb-IIIa Complex/*antagonists & inhibitors
- Regional Blood Flow
- *Thrombolytic Therapy
- Time Factors
- Treatment Outcome
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
Hitta via bibliotek
Till lärosätets databas
- Av författaren/redakt...
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Svensson, L.
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Aasa, M.
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Dellborg, Mikael ...
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Gibson, C. M.
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Kirtane, A.
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Herlitz, Johan, ...
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visa fler...
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Ohlsson, A.
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Karlsson, Thomas ...
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Grip, Lars, 1952
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visa färre...
- Artiklar i publikationen
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Am Heart J
- Av lärosätet
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Göteborgs universitet
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Högskolan i Borås
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Karolinska Institutet