Primary percutaneous coronary intervention vs conservative treatment for acute ST elevation myocardial infarction: short- and long-term follow-up according to disease severity

Circulation Journal : Official Journal of the Japanese Circulation Society
Ryo KoyanagiHIJAMI investigators

Abstract

Because there is insufficient evidence to support primary percutaneous coronary intervention (PPCI) as the treatment of acute myocardial infarction (AMI), this study elucidated the efficacy of PPCI according to disease severity. Between January 1999 and June 2001, 3,021 AMI patients were registered at Tokyo Women's Medical University and 17 affiliated institutions. Of these, 1,994 patients with ST-elevation AMI were admitted within 12 h of onset. PPCI was performed in 1,143 and 294 were treated conservatively. The 1,437 patients were grouped according to Thrombolysis In Myocardial Infarction-risk score: PPCI was performed in 59.5% of the low-risk group, 61.8% of the moderate-risk group, and 56.2% of the high-risk group. Cardiac death was the primary outcome. In the low-risk group, no significant differences were observed between PPCI and conservative therapy for 30-day and long-term cardiac mortality rates. In the moderate-risk group, the 30-day cardiac mortality rate for PPCI was significantly lower; however, no significant intergroup differences were observed for long-term cardiac mortality. In the high-risk group, 30-day and long-term cardiac mortality for PPCI were significantly more favourable than for conservative therapy...Continue Reading

References

Sep 19, 2001·JAMA : the Journal of the American Medical Association·D A MorrowE Braunwald
Sep 28, 2005·Circulation·Jens Jakob ThuneUNKNOWN Danish Multicenter Randomized Study on Fibrinolytic Therapy Versus Acute Coronary Angioplasty in Acute Myocardial Infarction
Oct 1, 2005·Circulation Journal : Official Journal of the Japanese Circulation Society·Kunihiro KinjoUNKNOWN Osaka Acute Coronary Insufficiency Study (OACIS) Group
Oct 8, 2005·American Heart Journal·Masaharu IshiharaUNKNOWN Japanese Acute Coronary Syndrome Study Investigators
May 3, 2007·JAMA : the Journal of the American Medical Association·Keith A A FoxUNKNOWN GRACE Investigators

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Citations

Aug 18, 2012·Chinese Journal of Integrative Medicine·Wen-hui DuanDa-zhuo Shi
Jun 25, 2010·Circulation Journal : Official Journal of the Japanese Circulation Society·Tatsuya MaruhashiHiroki Ikenaga
Mar 16, 2011·Circulation Journal : Official Journal of the Japanese Circulation Society·Hiroyo KuwabaraShinya Matsuda

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