Background: The proper time for the use of percutaneous coronary intervention (PCI) following the successful fibrinolysis for ST-segment elevation myocardial infarction (STEMI) for maximum efficiency and minimum side effects has not been determined yet. The present study was designed to compare the outcome of myocardial infarction patients who received fibrinolytic therapy with successful results and underwent PCI very early (within 3-12 h) (group 1) versus early (within 12-24 h) (group 2).
Methods: The study compared the occurrence of major adverse cardiac events during PCI (no-reflow phenomenon, access site bleeding, cerebral hemorrhage, and cardiac death). Patients were followed for 6 months after PCI for the occurrence of unstable angina, recurrent angina, non-STEMI, recurrent STEMI, repeat revascularization, heart failure, and cardiac death.
Results: Group 1 (121 patients) with the mean age of 59.93 ± 10.43 years were compared with group 2 (144 patients) with the mean age of 62.84 ± 10.22 years. Except for age, the 2 groups were not significantly different regarding baseline characteristics. No-reflow phenomenon was less in group 1 with p value = 0.005, whereas incidence of access site bleeding and cerebral hemorrhage were more in this group with p value = 0.001 and 0.049, respectively. During the period of 6 months' follow-up, recurrent angina and recurrent non-STEMI occurred more in group 2 with p value = 0.049 and 0.035, respectively, with no other significant difference between the 2 groups.
Conclusions: No-reflow phenomenon and the risk of recurrent ischemia is significantly lower in patients undergoing PCI very early after successful fibrinolytic therapy, but the risk of bleeding is increased in this time. So it is recommended that patients received successful fibrinolytic therapy to be subjected to very early PCI within 3 to 12 h from fibrinolysis.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.gheart.2018.06.003 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
When the heart deceives: a case report of hyperthyroidism disguised as STEMI in female pregnant patient.
Egypt Heart J
January 2025
Department of Cardiology and Vascular Medicine, Rumah Sakit Umum Daerah Gunung Jati, Kesambi Street No. 56, Cirebon, West Java, 45134, Indonesia.
Background: Acute myocardial infarction during pregnancy is a rare condition with an incidence of 1 to 10 per 100,000 deliveries. ST-elevation myocardial infarction (STEMI) is dominating the clinical presentation. It is estimated that 29% of the patients had normal coronary arteries, and hyperthyroidism may be associated with coronary vasospasm.
View Article and Find Full Text PDFDeep learning of noncontrast CT for fast prediction of hemorrhagic transformation of acute ischemic stroke: a multicenter study.
Eur Radiol Exp
January 2025
Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Background: Hemorrhagic transformation (HT) is a complication of reperfusion therapy following acute ischemic stroke (AIS). We aimed to develop and validate a model for predicting HT and its subtypes with poor prognosis-parenchymal hemorrhage (PH), including PH-1 (hematoma within infarcted tissue, occupying < 30%) and PH-2 (hematoma occupying ≥ 30% of the infarcted tissue)-in AIS patients following intravenous thrombolysis (IVT) based on noncontrast computed tomography (NCCT) and clinical data.
Methods: In this six-center retrospective study, clinical and imaging data from 445 consecutive IVT-treated AIS patients were collected (01/2018-06/2023).
Bayesian modeling framework for optimizing pre-hospital stroke triage decisions.
J Appl Stat
May 2024
Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, USA.
Ischemic stroke is responsible for significant morbidity and mortality in the United States and worldwide. Stroke treatment optimization requires emergency medical personnel to make rapid triage decisions concerning destination hospitals that may differ in their ability to provide highly time-sensitive pharmaceutical and surgical interventions. These decisions are particularly crucial in rural areas, where transport decisions can have a large impact on treatment times - often involving a trade-off between delay in pharmaceutical therapy or a delay in endovascular thrombectomy.
View Article and Find Full Text PDFIntegrating the ADS Score with 24-Hour ASPECTS and red cell distribution width for enhanced prediction of stroke-associated pneumonia following intravenous thrombolysis: model development and internal validation.
Eur J Med Res
January 2025
Division of Radiology, Saraburi Hospital, Saraburi, Thailand.
Introduction: Stroke-associated pneumonia (SAP) is a major cause of mortality during the acute phase of stroke. The ADS score is widely used to predict SAP risk but does not include 24-h non-contrast computed tomography-Alberta Stroke Program Early CT Score (NCCT-ASPECTS) or red cell distribution width (RDW). We aim to evaluate the added prognostic value of incorporating 24-h NCCT-ASPECTS and RDW into the ADS score and to develop a novel prediction model for SAP following thrombolysis.
View Article and Find Full Text PDFIntra-arterial tenecteplase after successful endovascular recanalisation in patients with acute posterior circulation arterial occlusion (ATTENTION-IA): multicentre randomised controlled trial.
BMJ
January 2025
Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
Objective: To assess whether intra-arterial tenecteplase administered after successful endovascular recanalisation improves outcomes in patients with acute arterial occlusion of the posterior circulation.
Design: Multicentre randomised controlled trial.
Setting: 31 hospitals in China, 24 January 2023 to 24 August 2023.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!