A Comparison of Outcomes of Routine Early Angiography versus Delayed Ischemia-Guided Angiography after Thrombolytic Therapy in ST Segment-Elevation Myocardial Infarction

HA  Basiri; Reza Kiani; S  Abdi; A  Zahedmehr; HR  Sanati; F  Shakerian; A  Firoozi

International Cardiovascular Research Journal

The Official Annually Journal of Cardiovascular Research Center, Shiraz University of Medical Sciences

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A Comparison of Outcomes of Routine Early Angiography versus Delayed Ischemia-Guided Angiography after Thrombolytic Therapy in ST Segment-Elevation Myocardial Infarction

Author(s):

HA Basiri¹,

Reza Kiani^1,*,

S Abdi¹,

A Zahedmehr¹,

HR Sanati¹,

F Shakerian¹,

A Firoozi¹

1Department of Interventional Cardiology, Shaheed Rajaie Cardiovascular Center, Tehran University of Medical Sciences, Tehran, Iran

International Cardiovascular Research Journal:Vol. 5, issue 2; e13996

Published online:Jun 30, 2011

Article type:Research Article

Received:May 27, 2017

Accepted:Apr 02, 2011

How to Cite:Basiri H, Kiani R, Abdi S, Zahedmehr A, Sanati H, et al. A Comparison of Outcomes of Routine Early Angiography versus Delayed Ischemia-Guided Angiography after Thrombolytic Therapy in ST Segment-Elevation Myocardial Infarction. Int Cardiovasc Res J. 2017;5(2):e13996. doi:

Abstract

Background: Thrombolytic therapy continues to be the common treatment in acute ST elevation myocardial infarction in the majority of heart centers worldwide. However, thrombolytic therapy is associated with high re-occlusion and re-infarction rates. So, most patients now undergo early diagnostic angiography and possibly angioplasty of the culprit artery but the controversy about the timing of angiography after thrombolysis continues to remain unresolved. In this prospective cohort study, we compared the outcome of early invasive strategy versus delayed invasive approach in ST-elevation MI patients who had received successful thrombolytic therapy. Primary endpoint of the study was Major Adverse Cardiovascular Events or MACE ( the combined rate of death, re-infarction, major bleeding and cerebrovasular events. Secondary endpoints were re-infarction and re-hospitalization rate.

Method: The study comprised 142 patients of which 87 had a routine angiography in less than 10 days of acute event and 55 underwent ischemia-guided angiography after 10 days of index event. Stenting of the culprit vessel was done in 60% of the routine angiography group and 63% of the ischemia-guided group. The patients were followed for 8.8 ± 2.8 months after the index event.

Results: The primary endpoint occurred in 6.9% of routine angiography patients and 10.9% of the control group (P= 0.4). The rate of re-infarction was significantly higher in the delayed invasive arm than routine early invasive arm (10.9% vs. 1.1, P:0.01),and mostly occurring before angiography.

Conclusion: routine angiography as soon as possible after thrombolysis can reduce re-infarction and was not associated with any increased risk of adverse events in our study.

Keywords

Coronary Angiography

Myocardial Infarction

Thrombolytic Therapy

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References

1.
The references are available in PDF.

Immediate versus Staged Complete Revascularization in Multi-Vessel Coronary Artery Disease Patients with ST-Elevation Myocardial Infarction Uncomplicated by Cardiogenic Shock

Nichita-Brendea Mihnea-Traian,

Virgil Popa,

Dorina-Carmen Polojintef-Corbu,

Mircea Popescu

Mihnea-Traian N, Popa V, Polojintef-Corbu D, Popescu M. Immediate versus Staged Complete Revascularization in Multi-Vessel Coronary Artery Disease Patients with ST-Elevation Myocardial Infarction Uncomplicated by Cardiogenic Shock. Int Cardiovasc Res J. 2021;15(3):e116878. doi:

2

Aug

2016

In-hospital and late outcome of rescue versus primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction

Hossein Vakili,

Roxana Sadeghi,

Solmaz Borjian,

Naser Kachoueian

Vakili H, Sadeghi R, Borjian S, Kachoueian N. In-hospital and late outcome of rescue versus primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction. Int J Cardiovasc Pract. 2016;1(2):e130035. doi: https://doi.org/10.20286/ijcp-010203

16

Mar

2019

Short-and Long-Term Follow-up in the Elderly Patients with ST-Elevation Myocardial Infarction Receiving Primary Angioplasty or Thrombolytic Therapy

Mohammad Kazem Kazemi,

Khalil Alimohammadzadeh,

Ali Maher

Kazemi MK, Alimohammadzadeh K, Maher A. Short-and Long-Term Follow-up in the Elderly Patients with ST-Elevation Myocardial Infarction Receiving Primary Angioplasty or Thrombolytic Therapy. Int J Cardiovasc Pract. 2019;4(1):e130287. doi: https://doi.org/10.21859/ijcp-403

25

Dec

2018

Predictors of the extent and severity of coronary artery disease for prognosis of patients with non-ST-segment elevation acute coronary syndromes

Chirag Patel,

Jayesh Prajapati,

Iva Patel,

Roopesh Singhal,

Ashish Mishra,

Gaurav Singh

Patel C, Prajapati J, Patel I, Singhal R, Mishra A, et al. Predictors of the extent and severity of coronary artery disease for prognosis of patients with non-ST-segment elevation acute coronary syndromes. Int J Cardiovasc Pract. 2018;3(4):e130285. doi: https://doi.org/10.21859/ijcp-03043

20

Feb

2014

Predicting the Culprit Lesion in Acute Inferior ST-Elevation Myocardial Infarction Based on Wellens’ Criteria and Tierala’s Algorithm

kaveh hosseini,

Ali Bozorgi,

Shahrokh Karbalayi

hosseini K, Bozorgi A, Karbalayi S. Predicting the Culprit Lesion in Acute Inferior ST-Elevation Myocardial Infarction Based on Wellens’ Criteria and Tierala’s Algorithm. Thrita J Neu. 2014;3(1):e93661. doi: https://doi.org/10.5812/thrita.15607

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Author(s):

HA Basiri:[PubMed][Scholar]
Reza Kiani:[PubMed][Scholar]
S Abdi:[PubMed][Scholar]
A Zahedmehr:[PubMed][Scholar]
HR Sanati:[PubMed][Scholar]
F Shakerian:[PubMed][Scholar]
A Firoozi:[PubMed][Scholar]

The Official Annually Journal of Cardiovascular Research Center, Shiraz University of Medical Sciences

Outlines

A Comparison of Outcomes of Routine Early Angiography versus Delayed Ischemia-Guided Angiography after Thrombolytic Therapy in ST Segment-Elevation Myocardial Infarction

Abstract

Fulltext

References

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