Abstract
Primary percutaneous coronary intervention (PPCI) has evolved, including the introduction of stents and platelet glycoprotein IIb/IIIa receptor inhibitors (GPI). The effects of these changes and other variables on long-term survival for a single-centre service were studied. A prospective database of clinical and angiographic variables were kept for patients treated with PPCI in Waikato Hospital from 1996 to 2006 (n=527). This was analysed with long-term mortality data. Survival was recorded using Kaplan-Meier curves. Multivariate analysis of factors at presentation, including ethnicity was performed. 5, 8 & 10-year survival rates were 76.5% (n=274), 72.7% (n=125) & 71.0% (n=19) respectively. Increased stent (42.8% vs. 84.1%, p<0.001) and GPI (39.6% vs. 73.3%, p<0.001) use was seen between early and late stages of the study. Stent use was associated with greater 5-year survival (80.5% vs. 70.8%, p=0.02), but GPI use was not. Multivariate analysis showed stent use independently predicted reduced mortality. Age, Maori ethnicity, renal failure and cardiogenic shock predicted higher mortality. Survival after PPCI remains high long-term. Stent and GPI use significantly increased. Stent, but not GPI, use was associated with improved s...Continue Reading
References
Mar 15, 1995·Circulation·K L LeeR M Califf
Mar 11, 1993·The New England Journal of Medicine·C L GrinesG C Timmis
Sep 4, 1998·Circulation·S J BrenerE J Topol
Mar 18, 1999·Journal of the American College of Cardiology·C M NunnC L Grines
Nov 5, 1999·The New England Journal of Medicine·F ZijlstraH Suryapranata
Dec 23, 1999·The New England Journal of Medicine·C L GrinesM C Morice
Mar 29, 2002·The New England Journal of Medicine·Gregg W StoneUNKNOWN Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC) Investigators
Jan 9, 2003·Lancet·Ellen C KeeleyCindy L Grines
Sep 24, 2004·Circulation·Padma KaulDaniel B Mark
Apr 9, 2005·Heart·G ParodiD Antoniucci
Apr 16, 2005·Heart·J P S HenriquesH Suryapranata
Sep 28, 2005·Circulation·Jens Jakob ThuneUNKNOWN Danish Multicenter Randomized Study on Fibrinolytic Therapy Versus Acute Coronary Angioplasty in Acute Myocardial Infarction
Aug 16, 2006·European Heart Journal·Lori MandelzweigUNKNOWN Euro Heart Survey Investigators
Oct 13, 2006·JAMA : the Journal of the American Medical Association·Ulf StenestrandUNKNOWN RIKS-HIA Registry
Jan 26, 2007·European Heart Journal·Gilles MontalescotEric Vicaut
Feb 15, 2007·European Heart Journal·Petr WidimskyUNKNOWN PRAGUE Study Group Investigators
Apr 10, 2007·Journal of the American College of Cardiology·Mauro MaioliRoberto Piero Dabizzi
Nov 17, 2007·European Heart Journal·Christos Kasapis, Brahmajee K Nallamothu