Switch to
| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
8579
|
| pubmed:dateCreated |
1988-3-2
|
| pubmed:abstractText |
A randomised trial of 367 patients with acute myocardial infarction was performed to determine whether an invasive strategy combining thrombolysis with recombinant tissue-type plasminogen activator (rTPA), heparin, and acetylsalicylic acid, and immediate percutaneous transluminal coronary angioplasty (PTCA) would be superior to a noninvasive strategy with the same medical treatment but without immediate angiography and PTCA. Intravenous infusion of 100 mg rTPA was started within 5 h after onset of symptoms (median 156 min). Angiography was performed 6-165 min later in 180 out of 183 patients allocated to the invasive strategy; 184 patients were allocated to the non-invasive strategy. Immediate PTCA reduced the percentage stenosis of the infarct-related segment, but this was offset by a high rate of transient (16%) and sustained (7%) reocclusion during the procedure and recurrent ischaemia during the first 24 h (17%). The clinical course was more favourable after non-invasive therapy, with a lower incidence of recurrent ischaemia within 24 h (3%), bleeding complications, hypotension, and ventricular fibrillation. Mortality at 14 days was lower in patients allocated to non-invasive treatment (3%) than in the group allocated to invasive treatment (7%). No difference between the treatment groups was observed in infarct size estimated from myocardial release of alpha-hydroxybutyrate dehydrogenase or in left ventricular ejection fraction after 10-22 days. Since immediate PTCA does not provide additional benefit there seems to be no need for immediate angiography and PTCA in patients with acute myocardial infarction treated with rTPA.
|
| pubmed:language |
eng
|
| pubmed:journal | |
| pubmed:citationSubset |
AIM
|
| pubmed:chemical |
http://linkedlifedata.com/resource/pubmed/chemical/Aspirin,
http://linkedlifedata.com/resource/pubmed/chemical/Fibrinolytic Agents,
http://linkedlifedata.com/resource/pubmed/chemical/Heparin,
http://linkedlifedata.com/resource/pubmed/chemical/Recombinant Proteins,
http://linkedlifedata.com/resource/pubmed/chemical/Tissue Plasminogen Activator
|
| pubmed:status |
MEDLINE
|
| pubmed:month |
Jan
|
| pubmed:issn |
0140-6736
|
| pubmed:author | |
| pubmed:issnType |
Print
|
| pubmed:day |
30
|
| pubmed:volume |
1
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
N
|
| pubmed:pagination |
197-203
|
| pubmed:dateRevised |
2007-11-15
|
| pubmed:meshHeading |
pubmed-meshheading:2893037-Adult,
pubmed-meshheading:2893037-Aged,
pubmed-meshheading:2893037-Angioplasty, Balloon,
pubmed-meshheading:2893037-Aspirin,
pubmed-meshheading:2893037-Clinical Trials as Topic,
pubmed-meshheading:2893037-Combined Modality Therapy,
pubmed-meshheading:2893037-Coronary Angiography,
pubmed-meshheading:2893037-Drug Therapy, Combination,
pubmed-meshheading:2893037-Europe,
pubmed-meshheading:2893037-Female,
pubmed-meshheading:2893037-Fibrinolytic Agents,
pubmed-meshheading:2893037-Heparin,
pubmed-meshheading:2893037-Humans,
pubmed-meshheading:2893037-Infusions, Intravenous,
pubmed-meshheading:2893037-Male,
pubmed-meshheading:2893037-Middle Aged,
pubmed-meshheading:2893037-Myocardial Infarction,
pubmed-meshheading:2893037-Random Allocation,
pubmed-meshheading:2893037-Recombinant Proteins,
pubmed-meshheading:2893037-Recurrence,
pubmed-meshheading:2893037-Time Factors,
pubmed-meshheading:2893037-Tissue Plasminogen Activator
|
| pubmed:year |
1988
|
| pubmed:articleTitle |
Thrombolysis with tissue plasminogen activator in acute myocardial infarction: no additional benefit from immediate percutaneous coronary angioplasty.
|
| pubmed:publicationType |
Journal Article,
Clinical Trial,
Comparative Study,
Randomized Controlled Trial
|