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Clinical impact of immediate invasive strategy in patients with non-ST-segment elevation myocardial infarction.

Abstract Immediate invasive approach for non-ST-segment elevation myocardial infarction (NSTEMI) may permit treatment of the underlying plaque rupture as early as possible with subsequent reduction of death and myocardial infarction (MI). We sought to assess clinical impact of immediate percutaneous coronary intervention (PCI) for NSTEMI.
PMID
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Authors

Mayor MeshTerms
Keywords

Bleeding

Myocardial infarction

Percutaneous coronary intervention

Journal Title international journal of cardiology
Publication Year Start




PMID- 27441472
OWN - NLM
STAT- In-Data-Review
DA  - 20160910
LR  - 20160910
IS  - 1874-1754 (Electronic)
IS  - 0167-5273 (Linking)
VI  - 221
DP  - 2016 Oct 15
TI  - Clinical impact of immediate invasive strategy in patients with non-ST-segment
      elevation myocardial infarction.
PG  - 937-43
LID - 10.1016/j.ijcard.2016.07.128 [doi]
LID - S0167-5273(16)31480-2 [pii]
AB  - BACKGROUND: Immediate invasive approach for non-ST-segment elevation myocardial
      infarction (NSTEMI) may permit treatment of the underlying plaque rupture as
      early as possible with subsequent reduction of death and myocardial infarction
      (MI). We sought to assess clinical impact of immediate percutaneous coronary
      intervention (PCI) for NSTEMI. METHODS: A total of 6134 NSTEMI patients
      undergoing PCI from the Korea Acute Myocardial Infarction Registry were divided
      into group 1 (immediate PCI within 4h, n=1132) and group 2 (non-immediate PCI
      after 4h, n=5002). Propensity-matched 12-month clinical outcome was compared.
      RESULTS: In all patients and propensity-matched cohort (n=1131 in each group),
      group 1 had higher peak troponin level, higher rate of pre-PCI Thrombolysis In
      Myocardial Infarction (TIMI) grade 0 or 1, higher use of glycoprotein IIb/IIIa
      inhibitor, and lower use of unfractionated heparin and nitrates. In all patients,
      12-month rates of MI and death/MI were higher in group 1. No differences were
      observed in 12-month death and major adverse cardiac events (MACE: composite of
      death, MI, target-vessel revascularization, and coronary artery bypass graft
      surgery). In propensity-matched cohort, no significant differences were observed 
      in 12-month rates of death, MI, death/MI or MACE. However, group 1 had less major
      bleeding (0.8% vs. 3.0%, p=0.024) and shorter hospital stay. CONCLUSIONS:
      Immediate PCI for patients with NSTEMI was associated with lower pre-PCI culprit 
      vessel patency and not with improved 12-month clinical outcome.
CI  - Copyright (c) 2016 Elsevier Ireland Ltd. All rights reserved.
FAU - Sim, Doo Sun
AU  - Sim DS
AD  - Chonnam National University Hospital, Gwangju, Republic of Korea.
FAU - Jeong, Myung Ho
AU  - Jeong MH
AD  - Chonnam National University Hospital, Gwangju, Republic of Korea. Electronic
      address: [email protected]
FAU - Ahn, Youngkeun
AU  - Ahn Y
AD  - Chonnam National University Hospital, Gwangju, Republic of Korea.
FAU - Kim, Young Jo
AU  - Kim YJ
AD  - Yeungnam University Hospital, Daegu, Republic of Korea.
FAU - Chae, Shung Chull
AU  - Chae SC
AD  - Kyungpuk National University Hospital, Daegu, Republic of Korea.
FAU - Hong, Taek Jong
AU  - Hong TJ
AD  - Busan National University Hospital, Busan, Republic of Korea.
FAU - Seong, In Whan
AU  - Seong IW
AD  - Chungnam National University Hospital, Daejon, Republic of Korea.
FAU - Chae, Jei Keon
AU  - Chae JK
AD  - Chunbuk National University Hospital, Jeonju, Republic of Korea.
FAU - Kim, Chong Jin
AU  - Kim CJ
AD  - Kyung Hee University Hospital, Seoul, Republic of Korea.
FAU - Cho, Myeong Chan
AU  - Cho MC
AD  - Chungbuk National University Hospital, Cheongju, Republic of Korea.
FAU - Rha, Seung-Woon
AU  - Rha SW
AD  - Korea University Guro Hospital, Seoul, Republic of Korea.
FAU - Bae, Jang Ho
AU  - Bae JH
AD  - Konyang University Hospital, Daejon, Republic of Korea.
FAU - Seung, Ki Bae
AU  - Seung KB
AD  - Catholic University Hospital, Seoul, Republic of Korea.
FAU - Park, Seung Jung
AU  - Park SJ
AD  - Asan Medical Center, Seoul, Republic of Korea.
CN  - other Korea Acute Myocardial Infarction Registry (KAMIR) Investigators
LA  - ENG
PT  - Journal Article
DEP - 20160711
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
SB  - IM
OTO - NOTNLM
OT  - Bleeding
OT  - Myocardial infarction
OT  - Percutaneous coronary intervention
EDAT- 2016/07/22 06:00
MHDA- 2016/07/22 06:00
CRDT- 2016/07/22 06:00
PHST- 2016/05/23 [received]
PHST- 2016/07/08 [accepted]
AID - S0167-5273(16)31480-2 [pii]
AID - 10.1016/j.ijcard.2016.07.128 [doi]
PST - ppublish
SO  - Int J Cardiol. 2016 Oct 15;221:937-43. doi: 10.1016/j.ijcard.2016.07.128. Epub
      2016 Jul 11.

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