PMID- 17573584
OWN - NLM
STAT- MEDLINE
DCOM- 20071005
LR  - 20101118
IS  - 1748-2941 (Print)
IS  - 1748-2941 (Linking)
VI  - 9
IP  - 2
DP  - 2007
TI  - Early percutaneous coronary intervention after fibrinolysis for acute ST 
      elevation myocardial infarction: results of two German multi-centre registries 
      (ACOS and GOAL).
PG  - 97-103
AB  - OBJECTIVES: We evaluated the outcome of early percutaneous coronary intervention 
      (PCI) after fibrinolysis in patients presenting with ST elevation myocardial 
      infarction (STEMI) in clinical practice. RESULTS: 2230 consecutive patients with 
      STEMI treated with fibrinolysis were divided into two groups: patients treated 
      with fibrinolysis only (n = 1540) or with additional PCI (n = 690) within a 
      median of 150 min. In-hospital mortality (9.3% versus 5.9%) and death/myocardial 
      re-infarction (13.9% versus 9.7%) occurred significantly less often in the PCI 
      group. After adjustment for the confounding factors in the propensity score 
      analysis PCI did not significantly affect hospital mortality (OR 0.88, 95% CI 
      0.57-1.36) and death/myocardial re-infarction (OR 0.86, 95% CI 0.61-1.20) in the 
      overall patients collective. Major bleeding complications were observed more 
      often in the PCI group (7.3% versus 4.2%). In patients with a higher risk profile 
      (TIMI risk score > or = 5) (n = 494) PCI was associated with a significant 
      reduction of hospital mortality (OR 0.40, 95% CI 0.20-0.78) and death/myocardial 
      re-infarction (OR 0.36, 95 % CI 0.19-0.67). CONCLUSIONS: In the overall patients' 
      collective early PCI after fibrinolysis is not associated with an improved 
      clinical outcome. However, in patients with a higher risk profile an early 
      invasive strategy is associated with a risk reduction for mortality and the 
      combined endpoint of death/myocardial re-infarction.
FAU - Bauer, Timm
AU  - Bauer T
AD  - Herzzentrum Ludwigshafen, Department of Cardiology. Ludwigshafen. Germany.
FAU - Koeth, Oliver
AU  - Koeth O
FAU - Junger, Claus
AU  - Junger C
FAU - Heer, Tobias
AU  - Heer T
FAU - Wienbergen, Harm
AU  - Wienbergen H
FAU - Gitt, Anselm
AU  - Gitt A
FAU - Senges, Jochen
AU  - Senges J
FAU - Zeymer, Uwe
AU  - Zeymer U
CN  - Acute Coronary Syndromes Registry (ACOS) Investigators
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PL  - England
TA  - Acute Card Care
JT  - Acute cardiac care
JID - 101276603
SB  - IM
MH  - Aged
MH  - *Angioplasty, Balloon, Coronary
MH  - Cohort Studies
MH  - Combined Modality Therapy
MH  - Female
MH  - Germany
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/mortality/*therapy
MH  - Recurrence
MH  - Registries
MH  - *Thrombolytic Therapy
MH  - Treatment Outcome
EDAT- 2007/06/19 09:00
MHDA- 2007/10/06 09:00
CRDT- 2007/06/19 09:00
PHST- 2007/06/19 09:00 [pubmed]
PHST- 2007/10/06 09:00 [medline]
PHST- 2007/06/19 09:00 [entrez]
AID - 779607321 [pii]
AID - 10.1080/17482940701397828 [doi]
PST - ppublish
SO  - Acute Card Care. 2007;9(2):97-103. doi: 10.1080/17482940701397828.