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RESEARCH PRODUCT
Resultados de la estrategia farmacoinvasiva y de la angioplastia primaria en la reperfusión del infarto con elevación del segmento ST. Estudio con resonancia magnética cardiaca en la primera semana y en el sexto mes
Vicente BodiRafael San-juanDavid MoratalMaria P. Lopez-lereuÀNgel LlàcerFrancisco J. ChorroJose V. MonmeneuJulio NúñezFabian ChaustreIsabel TraperoRicardo OltraPilar MerlosEva RumizMaria L. BlascoJuan Sanchissubject
MaleCardiac CatheterizationPropensity scoremedicine.medical_treatmentLeftHeart left ventricleCoronaryMyocardial InfarctionInfarctionMagnetic resonance angiographyVentricular Dysfunction LeftHeart infarction sizeVentricular DysfunctionMedicineThrombolytic TherapyMyocardial infarctionProspective StudiesAngioplasty Balloon Coronarycomparative studyeducation.field_of_studyEjection fractionmedicine.diagnostic_testGeneral MedicineMiddle AgedMagnetic Resonance ImagingThrombolysisDeathNuclear magnetic resonance imagingTreatment OutcomeHeart left ventricle endsystolic volumeCardiologyFemaleTIMIHumanmedicine.medical_specialtyHeart CatheterizationEndpoint DeterminationFibrinolytic agentPopulationMyocardial Reperfusion InjuryMajor clinical studyArticleTECNOLOGIA ELECTRONICAMagnetic resonance imagingInternal medicineAngioplastyHumansBlood clot lysisProspective studyeducationPrimary angioplastyAgedUniversity hospitalST segment elevation myocardial infarctionbusiness.industryAngioplastymedicine.diseaseSurgeryST-segment elevation myocardial infarctionOutcome assessmentHeart catheterizationReperfusionHeart muscle reperfusionbusinessControlled studyBalloonMagnetic Resonance AngiographyFollow-Up Studiesdescription
[EN] Introduction and objectives: Pharmacoinvasive strategy represents an attractive alternative to primary angioplasty. Using cardiovascular magnetic resonance imaging we compared the left ventricular outcome of the pharmacoinvasive strategy and primary angioplasty for the reperfusion of ST-segment elevation myocardial infarction. Methods: Cardiovascular magnetic resonance was performed 1 week and 6 months after infarction in two consecutive cohorts of patients included in a prospective university hospital ST-segment elevation myocardial infarction registry. During the period 2004-2006, 151 patients were treated with pharmacoinvasive strategy (thrombolysis followed by routine non-immediate angioplasty). During the period 2007-2008, 93 patients were treated with primary angioplasty. A propensity score matched population was also evaluated. Results: At 1-week cardiovascular magnetic resonance, pharmacoinvasive strategy and primary angioplasty patients showed a similar extent of area at risk (29 ± 15 vs. 29 ± 17%, P = .9). Non-significant differences were detected by cardiovascular magnetic resonance at 1 week and at 6 months in infarct size, salvaged myocardium, microvascular obstruction, ejection fraction, end-diastolic volume index and end-systolic volume index (P > .2 in all cases). The same trend was observed in 1-to-1 propensity score matched patients. The rate of major adverse cardiac events (death and/or re-infarction) at 1 year was 6% in pharmacoinvasive strategy and 7% in primary angioplasty patients (P = .7). Conclusions: A pharmacoinvasive strategy including thrombolysis and routine non-immediate angioplasty represents a widely available and logistically attractive approach that yields identical short-term and long-term cardiovascular magnetic resonance-derived left ventricular outcome compared to primary angioplasty. © 2010 Sociedad Española de Cardiología.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2011-01-01 |