PMID- 19205776
OWN - NLM
STAT- MEDLINE
DCOM- 20090518
LR  - 20211020
IS  - 1861-0692 (Electronic)
IS  - 1861-0684 (Linking)
VI  - 98
IP  - 4
DP  - 2009 Apr
TI  - Immediate versus delayed angioplasty in infarct-related arteries with TIMI III 
      flow and ST segment recovery: a matched comparison in acute myocardial infarction 
      patients.
PG  - 257-64
LID - 10.1007/s00392-009-0756-z [doi]
AB  - BACKGROUND: Early management of patients with patent infarct-related artery (IRA) 
      and optimal ST resolution in ST elevation myocardial infarction (STEMI) has never 
      been assessed. We compared immediate vs delayed PCI in these patients. METHODS: 
      Matched comparison of immediate vs delayed (24 h) PCI in STEMI patients 
      presenting with patent IRA, thrombus-containing lesion and ST resolution >or=70%. 
      Patients were matched for duration of symptoms, intervention type, angiographic 
      data, diabetes. Patients in immediate PCI group received standard therapy in the 
      cathlab. Patients in delayed PCI group received dual antiplatelet therapy, 
      antithrombins, and GPIIb-IIIa inhibitors until PCI. Primary endpoint was 
      procedural success. Secondary endpoints were enzyme release and in-hospital 
      adverse events. RESULTS: Seventy-eight patients were included: 39 per group. 
      Average age 62 years, 75% males. There was a significantly higher procedural 
      success rate in the delayed PCI group (95% success, Vs. 77% in the immediate 
      group, P = 0.008). Initial thrombus burden score did not differ between immediate 
      and delayed PCI groups, but improved significantly in the delayed group between 
      baseline angiography and time of PCI (P = 0.039). There was no difference in 
      major adverse events or bleeding complications between groups. Peak CK levels 
      were significantly higher in the immediate versus delayed PCI group (P = 0.02), 
      although there was no difference between groups in peak CK-MB, peak troponin, or 
      peak CK-MB ratio. CONCLUSION: Our data suggest that in STEMI patients with patent 
      IRA, optimal ST-segment resolution, and thrombus-containing lesion, deferred PCI 
      when patients are given dual antiplatelet therapy, antithrombin agents, and 
      GPIIb-IIIa inhibitors results in a higher procedural success rate, without an 
      increased risk of MACE.
FAU - Meneveau, Nicolas
AU  - Meneveau N
AD  - Department of Cardiology, University Hospital Jean Minjoz, Besancon, France. 
      nicolas.meneveau@univ-fcomte.fr
FAU - Seronde, Marie France
AU  - Seronde MF
FAU - Descotes-Genon, Vincent
AU  - Descotes-Genon V
FAU - Dutheil, Joanna
AU  - Dutheil J
FAU - Chopard, Romain
AU  - Chopard R
FAU - Ecarnot, Fiona
AU  - Ecarnot F
FAU - Briand, Florent
AU  - Briand F
FAU - Bernard, Yvette
AU  - Bernard Y
FAU - Schiele, Francois
AU  - Schiele F
FAU - Bassand, Jean-Pierre
AU  - Bassand JP
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20090209
PL  - Germany
TA  - Clin Res Cardiol
JT  - Clinical research in cardiology : official journal of the German Cardiac Society
JID - 101264123
RN  - 0 (Antithrombins)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 0 (Platelet Glycoprotein GPIIb-IIIa Complex)
SB  - IM
MH  - Aged
MH  - Angioplasty, Balloon, Coronary/*methods
MH  - Antithrombins/*therapeutic use
MH  - Coronary Angiography
MH  - Coronary Vessels/pathology
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*therapy
MH  - Platelet Aggregation Inhibitors/*therapeutic use
MH  - Platelet Glycoprotein GPIIb-IIIa Complex/antagonists & inhibitors
MH  - Retrospective Studies
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2009/02/12 09:00
MHDA- 2009/05/19 09:00
CRDT- 2009/02/12 09:00
PHST- 2008/09/19 00:00 [received]
PHST- 2009/01/08 00:00 [accepted]
PHST- 2009/02/12 09:00 [entrez]
PHST- 2009/02/12 09:00 [pubmed]
PHST- 2009/05/19 09:00 [medline]
AID - 10.1007/s00392-009-0756-z [doi]
PST - ppublish
SO  - Clin Res Cardiol. 2009 Apr;98(4):257-64. doi: 10.1007/s00392-009-0756-z. Epub 
      2009 Feb 9.