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2001, Number S1

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Arch Cardiol Mex 2001; 71 (S1)

Mechanical reperfusion in acute myocardial infarction

Martínez RMA
Full text How to cite this article

Language: Spanish
References: 7
Page: 127-130
PDF size: 37.51 Kb.


Key words:

Acute Myocardial Infarction, Primary Angioplasty (pPTCA), Primary Angioplasty with Stent (pPTCA + Stent).

ABSTRACT

Nowadays, it has been demonstrated that reperfussion therapy in acute myocardial infarction diminishes mortality and improves ventricular function. Primary percutaneous transluminal coronary angioplasty (ACTPp) was described in 1983 by Hartzler as an alternative treatment in acute myocardial infarction. The results of this procedure were considered excellent. In 1996 the committee built up by the ACC/AHA published in the 1999 updated JACC’s issue, a statement of the position that occupied at that moment primary angioplasty in the treatment of acute myocardial infarction. This committee pointed that this therapy showed to be an excellent alternative compared with the use of thrombolytic agents in acute myocardial infarction with ST elevation, patients who presented ‹ 12 hs of the onset of symptoms according to the following conditions: 1. In less time, 2. Supported by trained staff, and 3. In an experience cath lab. This comumunication was introduced prior to the use of interventionist therapy with stents with or without the utilization of glycoproteins inhibitors. The analisys of results of different comparative studies of ACTPp with or without stents vs the use with or without II/IIIa glycoproteins inhibitors, was also included in this communication; among them it stands out the epistent which demonstrated less events as far as 6 months and was statistical significant in patients treated with Stent and abciximad. In conclusion we believe that ACTPp with Stent and glycoprotein inhibitors offers better results than those obtained from a combined therapy with thrombolytic agents and IIb/IIIa, however, we must recognise that there are limitations when performing angioplasty, as there is a lack of an efficient 24 hr. cath lab.


REFERENCES

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  2. THE GUSTO INVESTIGATORS. An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction. N Engl J Med 1993; 329: 673-82.

  3. THE PLATELET RECEPTOR INHIBITION IN ISCHEMIC SYNDROME MANAGEMENT STUDY INVESTIGATORS: A comparison of aspirin plus tirofiban with aspirin plus heparin for unstable angina. N Engl J Med 1998; 338: 1498-505.

  4. TOPOL EJ: Textbook of intervenctional Cardiology. 3rd Ed. Philadelphia, Pennsylvania W.B. Sawnders Company, 1999.

  5. RYAN TJ, ANDERSON JL, ANTMAN EM, BRANIFF BA, BROOKS NH, CALIFF RM, ET AL: ACC/AHA guidelines for the management of patients with acute myocardial infarction: a report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines (Committe on Management of Acute Myocardial Infarction). J Am Coll Cardiol 1996; 28: 1328-428.

  6. SCHOMIG A, KASTRATI A, DIRSCHINGER J, MECHILLI J, SCHRICKE U, PACHE J, ET AL: MARTINOFF S, NEUMANN FJ, SCHWAIGER M: Coronary stenting plus platelet glycoprotein IIb/IIIa blockade compared with tissue plasminogen activator in acute myocardial infarction. Stent versus thrombolysis for Occluded Coronary Arteries in Patients with Acute Myocardial infarction study Investigators. N Engl J Med 2000; 10; 343: 385-91.

  7. STONE G: Meeting Latest Trial News. November, 2000 www.cardiosource.com/trials/trialnews.asp.




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C?MO CITAR (Vancouver)

Arch Cardiol Mex. 2001;71