Journal article
Culprit-Vessel Percutaneous Coronary Intervention Followed by Contralateral Angiography versus Complete Angiography in Patients with ST-Elevation Myocardial Infarction
Texas Heart Institute journal, Vol.39(3), pp.359-364
01/01/2012
PMCID: PMC3368457
PMID: 22719144
Abstract
In patients with ST-elevation myocardial infarction, delay in door-to-balloon time strongly increases mortality rates. To our knowledge, no randomized studies to date have focused on reducing delays within the catheterization laboratory.
We performed a retrospective analysis of all patients who presented with ST-elevation myocardial infarction at our institution from July 2006 through June 2010, looking primarily at time differences between percutaneous coronary intervention in the culprit vessel on the basis of ECG criteria, followed by contralateral angiography (Group 1), versus complete coronary angiography followed by culprit-vessel percutaneous intervention (Group 2).
There were 49 patients in Group 1 and 57 patients in Group 2. No major differences in baseline characteristics were observed between the groups, except a higher prevalence of diabetes mellitus in Group 2. There was a statistically significant difference between Groups 1 and 2 in door-to-balloon time (median and interquartile range, 75 min [61–89] vs 87 min [70–115], P=0.03, respectively) and access-to-balloon time (12 min [9–18] vs 21 min [11–33], P=0.0006, respectively). Five Group 1 patients (10%) with inferior myocardial infarction had a contralateral culprit vessel. There were no differences in mortality rate or ejection fraction at the median 1-year follow-up. Four patients in Group 1 and 3 patients in Group 2 were referred for coronary artery bypass grafting after percutaneous intervention.
This study suggests that performing culprit-vessel percutaneous intervention on the basis of electrocardiographic criteria, followed by angiography in patients with anterior ST-elevation myocardial infarction, might be the preferred approach, given the door-to-balloon time that is saved.
Details
- Title: Subtitle
- Culprit-Vessel Percutaneous Coronary Intervention Followed by Contralateral Angiography versus Complete Angiography in Patients with ST-Elevation Myocardial Infarction
- Creators
- Chadi Dib - University of Oklahoma Health Sciences CenterElias B. Hanna - University of Oklahoma Health Sciences CenterMuhammad A. Chaudhry - University of Oklahoma Health Sciences CenterThomas A. Hennebry - University of Oklahoma Health Sciences CenterStavros Stavrakis - University of Oklahoma Health Sciences CenterMazen S. Abu-Fadel - University of Oklahoma Health Sciences Center
- Resource Type
- Journal article
- Publication Details
- Texas Heart Institute journal, Vol.39(3), pp.359-364
- Publisher
- Texas Heart Institute
- PMID
- 22719144
- PMCID
- PMC3368457
- ISSN
- 0730-2347
- eISSN
- 1526-6702
- Language
- English
- Date published
- 01/01/2012
- Academic Unit
- Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9984360159002771
Metrics
9 Record Views