From the Department of Cardiology, Hospital De Weezenlanden, Zwolle, the
Netherlands.
Correspondence to Harry Suryapranata, MD, PhD, Department of Cardiology, Hospital De Weezenlanden, Groot Wezenland 20, 8011 JW Zwolle, Netherlands.
Methods and Results—Patients with acute myocardial infarction
were randomly assigned to undergo either primary stenting (n=112) or
balloon angioplasty (n=115). The clinical end points were death,
recurrent infarction, subsequent bypass surgery, or repeat angioplasty
of the infarct-related vessel. The overall mortality rate at 6 months
was 2%. Recurrent infarction occurred in 8 patients (7%) after
balloon angioplasty and in 1 (1%) after stenting
(P=0.036). Subsequent target-vessel
revascularization was necessary in 19 (17%) and 4
(4%) patients, respectively (P=0.0016). The cardiac
event-free survival rate in the stent group was significantly higher
than in the balloon angioplasty group (95% versus 80%;
P=0.012).
Conclusions—In selected patients with acute myocardial
infarction, primary stenting can be applied safely and effectively,
resulting in a lower incidence of recurrent infarction and a
significant reduction in the need for subsequent target-vessel
revascularization compared with balloon
angioplasty.
Bare Palmaz-Schatz stents (Cordis) were mounted on the balloon
used for predilation. If necessary, high-pressure inflation was
performed with a bigger balloon. Angiographic success, subacute
occlusion, and bailout stenting were defined as previously
described.5 Prolonged inflation had to be
attempted before bailout stenting was considered. Bailout stenting did
not constitute an end point because it is perceived as an integral part
of an angioplasty strategy. Quantitative coronary angiography
was analyzed by an independent core laboratory (Cardialysis)
blinded to all clinical data and outcome.
The initial poststenting regimen was as follows: heparin infusion was
started 2 hours after sheath removal and continued until International
Normalized Ratio values had reached therapeutic levels. Warfarin was
given for
Clinical end points were death of any cause, recurrent MI, subsequent
bypass surgery, or repeat angioplasty of the IRV. Recurrent MI was
defined as previously described.1 The indication
for a second intervention had to be substantiated by symptoms or by ECG
or scintigraphic evidence of ischemia at rest or during
exercise. Subsequent revascularization involving
other coronary arteries did not constitute an end point. All
events were reviewed by 2 cardiologists blinded to treatment
assignments.
Using an anticipated 2-sided test for differences in independent
binomial proportions at the 5% significance level with a power of
90%, 211 patients (105 in each group) were required to detect a
reduction in a composite end point from 35% to 16%. Data were
analyzed by use of a single comparison between groups according
to the intention-to-treat principle. Continuous variables were
expressed as mean±SD and compared by use of Student's t
test, whereas discrete variables were given as absolute values and
percentages. The
Figure 1
However, the major limitation of the present trial is the fact that
the results were obtained from a single high-volume center, involving a
limited number of patients, and might be biased by the selection of
those patients who were in relatively stable
hemodynamic condition and in whom the IRV was
considered to be technically and anatomically ideal for stenting. In
fact, this limitation prevented at least half of all patients deemed
suitable for primary angioplasty from being randomized. Therefore, the
results may not be generalizable to all patients with acute MI. To
address this limitation in our currently ongoing trial, all patients
with acute MI are now randomized before coronary angiography.
Although the mortality rate (2%) was comparable to our previous
trial,1 no difference could be observed between
groups. In fact, it would be unlikely that stenting could further
reduce the low mortality rate achieved by balloon angioplasty.
To determine the predictors of adverse events,
multivariate analysis was performed by
combining both study groups. Male sex, Killip class >2, and treatment
with balloon angioplasty were associated with an increased risk of
adverse cardiac events (Table 4
Received December 5, 1997;
revision received February 13, 1998;
accepted February 21, 1998.
2.
Grines CL, Browne KF, Marco J, Rothbaum D, Stone GW,
O'Keefe J, Overlie P, Donohue B, Chelliah N, Timmis GC, Vlietstra R,
Strzelecki M, Puchrowicz-Ochocki S, O'Neill WW. A comparison of
immediate angioplasty with thrombolytic therapy for
acute myocardial infarction. N Engl J Med. 1993;328:673–679.
3.
De Boer MJ, Suryapranata H, Hoorntje JCA, Reiffers S,
Liem AL, Miedema K, Hermens WTh, van den Brand MJBM, Zijlstra F.
Limitation of infarct size and preservation of left
ventricular function after primary coronary
angioplasty compared with intravenous streptokinase in
acute myocardial infarction. Circulation. 1994;90:753–761.
4.
Fischman DL, Leon MD, Baim D, Schatz RA, Savage MP,
Penn I, Detre K, Veltri L, Ricci D, Nobuyoshi M, Cleman M, Heuser R,
Almond D, Teirstein PS, Fish RD, Colombo A, Brinker J, Moses J,
Shaknovich A, Hirshfeld J, Bailey S, Ellis S, Rake R, Goldberg S. A
randomized comparison of coronary stent placement and balloon
angioplasty in the treatment of coronary artery disease.
N Engl J Med. 1994;331:496–501.
5.
Serruys PW, de Jaegere P, Kiemeneij F, Macaya C,
Rutsch W, Heyndrickx G, Emanuelsson H, Marco J, Legrand V, Materne
P, Belardi J, Sigwart U, Colombo A, Goy JJ, van den Heuvel P, Delcan J,
Morel MA, for the Benestent Study Group. A comparison of balloon
expandable stent implantation with balloon angioplasty in patients with
coronary artery disease. N Engl J Med. 1994;331:489–495.
6.
Schömig A, Neumann FJ, Walter H, Schühlen
H, Hadamitzky M, Zitzmann-Roth EM, Dirschinger J, Hausleiter J, Blasini
R, Schmitt C, Alt E, Kastrati A. Coronary stent placement in
patients with acute myocardial infarction: comparison of clinical and
angiographic outcome after randomization to antiplatelet or
anticoagulant therapy. J Am Coll Cardiol. 1997;29:28–34.[Abstract]
7.
Saito S, Hosokawa G, Kim K, Tanaka S, Miyake S.
Primary stent implantation without Coumadin in acute myocardial
infarction. J Am Coll Cardiol. 1996;28:74–81.[Abstract]
8.
Antoniucci D, Valenti R, Buonamici P, Santoro GM,
Leoncini M, Bolognese L, Fazzini PF. Direct angioplasty and stenting of
the infarct-related artery in acute myocardial infarction.
Am J Cardiol. 1996;78:568–571.[Medline]
[Order article via Infotrieve]
9.
Neumann FJ, Walter H, Richardt G, Schmitt C,
Schömig A. Coronary Palmaz-Schatz stent implantation in
acute myocardial infarction. Heart. 1996;75:121–126.
10.
Garcia-Cantu E, Spaulding C, Corcos T, Hamda KB,
Roussel L, Favereau X, Guérin Y, Chalet Y, Souffrant G,
Guérin F. Stent implantation in acute myocardial infarction.
Am J Cardiol. 1996;77:451–454.[Medline]
[Order article via Infotrieve]
11.
Rodriguez AE, Fernandez M, Santaera O, Larribau M,
Bernardi V, Castaño, Palacios IF. Coronary stenting in
patients undergoing percutaneous transluminal
coronary angioplasty during acute myocardial infarction.
Am J Cardiol. 1996;77:685–689.[Medline]
[Order article via Infotrieve]
12.
Le May MR, Labinaz M, Beanlands RSB, Laramée LA,
O'Brien ER, Marquis JF, Williams WL, Al-Sadoon K, Davies RF, Kearns
SA, Johansen HL, Higginson LA. Usefulness of intracoronary
stenting in acute myocardial infarction. Am J Cardiol. 1996;78:148–152.[Medline]
[Order article via Infotrieve]
13.
Steinhubl SR, Topol EJ. Stenting for acute myocardial
infarction. Lancet. 1997;350:532–533.
14.
Schömig A, Neumann FJ, Kastrati A, Schühlen
H, Blasini R, Hadamitzky M, Walter H, Zitzmann-Roth EM, Richardt G, Alt
E, Schmitt C, Ulm K. A randomized comparison of antiplatelet and
anticoagulant therapy after the placement of coronary artery
stents. N Engl J Med. 1996;334:1084–1089.
© 1998 American Heart Association, Inc.
Clinical Investigation and Reports
Randomized Comparison of Coronary Stenting With Balloon Angioplasty in Selected Patients With Acute Myocardial Infarction
Abstract
Top
Abstract
Introduction
Methods
Results
Discussion
References
Background—Although the benefits of
primary angioplasty in acute myocardial infarction have been
demonstrated, several areas for improvement remain. Therefore, a
prospective randomized trial comparing primary stenting with balloon
angioplasty in patients with acute myocardial infarction was
conducted.
Key Words: stents • myocardial infarction • angioplasty
Introduction
Top
Abstract
Introduction
Methods
Results
Discussion
References
Primary angioplasty
in acute myocardial infarction (MI) has been shown to result in lower
rates of mortality, recurrent MI, and stroke compared with
thrombolysis.1 2 3 However,
recurrent ischemia and early reocclusion of the infarct-related
vessel (IRV) occur in 10% to 15% of patients after initially
successful angioplasty, and late restenosis (25% to 45%)
requiring repeat revascularization in the first 6
months remains disappointingly high.1 2 3 Although
coronary stenting may potentially overcome some of the major
limitations of balloon angioplasty,4 5 currently
available data on stenting in acute MI have been obtained only from
nonrandomized trials or from retrospective analysis of patients
who underwent stenting as a bailout
procedure.6 7 8 9 10 11 12 13 Therefore, a prospective
randomized trial comparing stenting with balloon angioplasty in acute
MI was conducted.
Methods
Top
Abstract
Introduction
Methods
Results
Discussion
References
The protocol was approved by our institutional review board.
Inclusion criteria were patients with acute MI who presented
within 6 hours after symptom onset, or between 6 and 24 hours if they
had persistent symptoms with evidence of ongoing ischemia, and
in whom the culprit lesion was located in a native coronary
artery that was considered suitable for stenting. Clinical exclusion
criteria were inability to give informed consent owing to prolonged
cardiopulmonary resuscitation or cardiogenic shock (Killip
class 4 at admission, requiring mechanical ventilation), participation
in another study, life expectancy of <1 year, and factors that would
make follow-up unlikely. History of previous bypass surgery, previous
angioplasty, or previous MI were not reasons for exclusion. The
decision to include a patient was made after the IRV was identified and
reperfusion was achieved with a guidewire and a balloon. Angiographic
exclusion criteria were unprotected left main disease or severe
multivessel disease necessitating urgent bypass surgery, target lesion
located in a bifurcation with a large side branch or located in a
diffuse sclerotic IRV, excessive proximal vessel tortuosity, inability
to cross the target lesion with a guidewire, no-reflow phenomenon, or
extensive thrombus throughout the IRV. After they provided informed
consent, patients were randomized to undergo primary stenting or
balloon angioplasty by means of a closed-envelope system. 
3 months and aspirin (80 mg/d) indefinitely. However,
because it became clear that ticlopidine was more effective in
preventing stent thrombosis,14 and given the fact
that anticoagulation therapy increases the risk of major bleeding
complications,4 5 our poststenting regimen
protocol was modified accordingly. From January 1996, only ticlopidine
(250 mg/d for 2 weeks) and aspirin were given after stenting, and
warfarin derivates were no longer used. Heparin infusion (1 mg ·
kg-1 · h-1) or
subcutaneous low-molecular-weight heparin (0.6 mL BID) was given for 48
hours after sheath removal in all patients, regardless of initial
treatment allocation. Thrombolytic therapy, platelet
glycoprotein IIb/IIIa receptor antagonists, and
intravascular ultrasound were not used. 
2 test was used to compare
proportions, or a Fisher's exact test was used when appropriate. The
differences in event rates between groups during the follow-up period
were assessed by the Kaplan-Meier method using the log-rank test.
Multivariate analysis was performed by use of
the Cox proportional hazard method, permitting calculation of odds
ratios that may be interpreted as relative risks with 95% CIs. All
statistical tests were 2-tailed.
Results
Top
Abstract
Introduction
Methods
Results
Discussion
References
From June 1995 to March 1997, a total of 532 patients with acute
MI have been admitted to our institution, of whom 498 underwent
immediate coronary angiography. One patient died before
angiography could be performed, and coronary angiography was
not performed in 12 patients who were involved in another trial and 21
patients who presented >24 hours after symptom onset. Of those
498 patients undergoing coronary angiography, 25 with a small
patent IRV were treated conservatively and 21 with severe triple-vessel
disease were referred for immediate bypass surgery. The remaining 452
patients underwent primary angioplasty. Of these, 225 were excluded
from the trial for various reasons (Table 1
), and 227 eligible patients were
randomized to undergo primary stenting (n=112) or balloon angioplasty
(n=115). Most (89, or 79%) of the randomized patients in the stent
group and 92 (80%) in the balloon angioplasty group were recruited in
the trial after the protocol was amended and the modified poststenting
regimen was adopted. Baseline characteristics and in-hospital outcome
are listed in Table 2 and are compared
with those of patients who were excluded from the trial. Subacute
occlusion occurred in 5 patients allocated to balloon angioplasty, on
the same day as the initial procedure in 4 and at day 9 in 1 patient.
Repeat angioplasty followed by stenting was performed in all patients,
but 4 had a recurrent MI. Only 1 stent patient had subacute
occlusion and recurrent MI at day 4 and underwent bypass surgery.
Quantitative angiographic results are shown in Table 3.
View this table:
[in a new window]
Table 1. Reasons for Exclusion in Candidates for Primary
Angioplasty (n=225)
View this table:
[in a new window]
Table 2. Baseline Characteristics and In-Hospital Events
View this table:
[in a new window]
Table 3. Quantitative Angiographic Results shows clinical outcome at 6
months. There were only 5 deaths (2%). Recurrent MI occurred in 1
patient after stenting and in 8 after balloon angioplasty
(P=0.036). Subsequent target-vessel
revascularization was necessary in 4 and 19
patients after stenting or balloon angioplasty, respectively
(P=0.0016). Consequently, the cardiac event-free survival
rate of 95% in the stent group was significantly higher than the 80%
in the balloon angioplasty group (P=0.0012). Figure 2 shows the Kaplan-Meier survival curves
in both groups. No patient was lost to follow-up. Non–target-vessel
revascularization was performed in 6 (5%) and 4
(3%) patients, respectively. Table 4
shows multivariate analysis of predictors of
cardiac events in all patients, regardless of treatment allocation.
View larger version (21K):
[in a new window]
Figure 1. Clinical outcome at 6 months in both study groups.
re-MI indicates recurrent myocardial infarction; TVR, target-vessel
revascularization.
View larger version (14K):
[in a new window]
Figure 2. Kaplan-Meier cardiac event-free survival
curves in both study groups during the 6-month follow-up period. The
left panel represents patients without death or recurrent
myocardial infarction (MI) and the right panel represents those
without any cardiac events (death, recurrent MI, or subsequent
target-vessel revascularization).
View this table:
[in a new window]
Table 4. Multivariate Analysis of
Predictors of Adverse Cardiac Events
Discussion
Top
Abstract
Introduction
Methods
Results
Discussion
References
The present trial indicates for the first time in a
prospective, randomized manner that primary stenting can be applied
safely and effectively in selected patients with acute MI, resulting in
a significant reduction in recurrent MI and subsequent target-vessel
revascularization compared with balloon
angioplasty. 
). Because most patients who were
excluded from the trial had more complex coronary
anatomy, had multivessel disease, were in Killip class 4, and
more often needed an intra-aortic balloon pump, the initial success
rate was lower than that of the study population (Table 2). All of
these factors may have contributed to the higher rates of death,
recurrent MI, and subsequent target-vessel
revascularization, as well as a longer hospital
stay. Despite this fact, the mortality rate in patients excluded from
the present study compares favorably with patients treated with
thrombolytic therapy.1 2 3
Although the mean diameter stenosis of 17.9% after stenting
seems to be relatively high for a low incidence of target-vessel
revascularization (4%), this is still lower than
the 22% reported in patients with stable
angina.5 In addition, patients selected for the
present trial had bigger vessels than patients in other randomized
trials,4 5 with poststenting reference diameter
of 3.15 mm. Most (80%) of the randomized patients were included
after our poststenting regimen was modified to exclude use of
anticoagulants. This led to fewer bleeding complications and a shorter
hospital stay compared with earlier reports.4 5
In fact, all bleeding complications occurred in the beginning of the
present trial, before this strategy was adopted and aggressive
anticoagulation was used. This protocol amendment was supported by
studies reporting stenting in acute MI without conventional
anticoagulation.6 7 Finally, the implications of
the present study with respect to cost-effectiveness require a
formal analysis, which will be performed after 1 year of
follow-up.
References
Top
Abstract
Introduction
Methods
Results
Discussion
References
1.
Zijlstra F, de Boer MJ, Hoorntje JCA, Reiffers S,
Reiber JHC, Suryapranata H. A comparison of immediate
coronary angioplasty with intravenous streptokinase
in acute myocardial infarction. N Engl J Med. 1993;328:680–684.
This article has been cited by other articles:
 |
|
 |
|
  M. Brueck, D. Bandorski, W. Kramer, M. Wieczorek, R. Holtgen, and H. Tillmanns A Randomized Comparison of Transradial Versus Transfemoral Approach for Coronary Angiography and Angioplasty J. Am. Coll. Cardiol. Intv., November 1, 2009; 2(11): 1047 - 1054. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. J. Hong, M. H. Jeong, Y. H. Choi, J. S. Ko, M. G. Lee, W. Y. Kang, S. E. Lee, S. H. Kim, K. H. Park, D. S. Sim, et al. Impact of plaque components on no-reflow phenomenon after stent deployment in patients with acute coronary syndrome: a virtual histology-intravascular ultrasound analysis Eur. Heart J., February 19, 2009; (2009) ehp034v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. J. Hong, M. H. Jeong, Y. Ahn, D. S. Sim, J. W. Chung, J. S. Cho, N. S. Yoon, H. J. Yoon, J. Y. Moon, K. H. Kim, et al. Plaque prolapse after stent implantation in patients with acute myocardial infarction an intravascular ultrasound analysis. J. Am. Coll. Cardiol. Img., July 1, 2008; 1(4): 489 - 497. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Sianos, M. I. Papafaklis, J. Daemen, S. Vaina, C. A. van Mieghem, R. T. van Domburg, L. K. Michalis, and P. W. Serruys Reply. J. Am. Coll. Cardiol., March 11, 2008; 51(10): 1047 - 1047. [Full Text] [PDF]
|
|
|
|
 |
|
 J. M. Wilson and J. T. Willerson Myocardial Revascularization with Percutaneous Devices Card. Surg. Adult, January 1, 2008; 3(2008): 573 - 598. [Full Text]
|
|
|
|
 |
|
 T. Svilaas, I. C C van der Horst, and F. Zijlstra A quantitative estimate of bare-metal stenting compared with balloon angioplasty in patients with acute myocardial infarction: angiographic measures in relation to clinical outcome Heart, July 1, 2007; 93(7): 792 - 800. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R J van der Schaaf, J R Timmer, J P Ottervanger, J C A Hoorntje, M-J de Boer, H Suryapranata, F Zijlstra, and J-H E Dambrink Long-term impact of multivessel disease on cause-specific mortality after ST elevation myocardial infarction treated with reperfusion therapy Heart, December 1, 2006; 92(12): 1760 - 1763. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. De Luca, H. Suryapranata, J. Timmer, J. P. Ottervanger, A. W.J. van't Hof, J. C.A. Hoorntje, J.-H. Dambrink, A.T. M. Gosselink, and M.-J. de Boer Impact of Routine Stenting on Clinical Outcome in Diabetic Patients Undergoing Primary Angioplasty for ST-Segment Elevation Myocardial Infarction Diabetes Care, April 1, 2006; 29(4): 920 - 923. [Full Text] [PDF]
|
|
|
|
 |
|
 P. W. Serruys, M. J.B. Kutryk, and A. T.L. Ong Coronary-Artery Stents N. Engl. J. Med., February 2, 2006; 354(5): 483 - 495. [Full Text] [PDF]
|
|
|
|
 |
|
 T. P. Wharton Jr, E. C. Keeley, C. L. Grines, T. P. Wharton Jr, E. C. Keeley, and C. L. Grines The Case for Community Hospital Angioplasty Circulation, November 29, 2005; 112(22): 3509 - 3534. [Full Text] [PDF]
|
|
|
|
|
|
G. De Luca, H. Suryapranata, G. Gregorio, H. Lange, and M. Chiariello Homocysteine and Its Effects on In-Stent Restenosis Circulation, November 8, 2005; 112(19): e307 - e311. [Full Text] [PDF]
|
|
|
|
 |
|
 C.-L. Hang, C.-P. Wang, H.-K. Yip, C.-H. Yang, G. B.-F. Guo, C.-J. Wu, and S.-M. Chen Early Administration of Intracoronary Verapamil Improves Myocardial Perfusion During Percutaneous Coronary Interventions for Acute Myocardial Infarction Chest, October 1, 2005; 128(4): 2593 - 2598. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Migliorini and D. Antoniucci Patient selection bias in primary percutaneous coronary intervention trials: a critical issue Eur. Heart J. Suppl., October 1, 2005; 7(suppl_I): I21 - I26. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. De Luca, H. Suryapranata, R. Grimaldi, and M. Chiariello Coronary stenting and abciximab in primary angioplasty for ST-segment-elevation myocardial infarction QJM, September 1, 2005; 98(9): 633 - 641. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A-A Fassa, P Urban, D Radovanovic, N Duvoisin, J-M Gaspoz, J-C Stauffer, P Erne, and for the AMIS Plus Investigators Trends in reperfusion therapy of ST segment elevation myocardial infarction in Switzerland: six year results from a nationwide registry Heart, July 1, 2005; 91(7): 882 - 888. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Sciagra, G. Parodi, A. Pupi, A. Migliorini, R. Valenti, G. Moschi, G. M. Santoro, G. Memisha, and D. Antoniucci Gated SPECT Evaluation of Outcome After Abciximab-Supported Primary Infarct Artery Stenting for Acute Myocardial Infarction: The Scintigraphic Data of the Abciximab and Carbostent Evaluation (ACE) Randomized Trial J. Nucl. Med., May 1, 2005; 46(5): 722 - 727. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H Suryapranata, G De Luca, A W J van 't Hof, J P Ottervanger, J C A Hoorntje, J-H E Dambrink, A T M Gosselink, F Zijlstra, and M-J de Boer Is routine stenting for acute myocardial infarction superior to balloon angioplasty? A randomised comparison in a large cohort of unselected patients Heart, May 1, 2005; 91(5): 641 - 645. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Authors/Task Force Members, S. Silber, P. Albertsson, F. F. Aviles, P. G. Camici, A. Colombo, C. Hamm, E. Jorgensen, J. Marco, J.-E. Nordrehaug, et al. Guidelines for Percutaneous Coronary Interventions: The Task Force for Percutaneous Coronary Interventions of the European Society of Cardiology Eur. Heart J., April 2, 2005; 26(8): 804 - 847. [Full Text] [PDF]
|
|
|
|
|
|
G. Guagliumi, G. W. Stone, D. A. Cox, T. Stuckey, J. E. Tcheng, M. Turco, G. Musumeci, J. J. Griffin, A. J. Lansky, R. Mehran, et al. Outcome in Elderly Patients Undergoing Primary Coronary Intervention for Acute Myocardial Infarction: Results From the Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC) Trial Circulation, September 21, 2004; 110(12): 1598 - 1604. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. C. Keeley and C. L. Grines Primary Percutaneous Coronary Intervention for Every Patient with ST-Segment Elevation Myocardial Infarction: What Stands in the Way? Ann Intern Med, August 17, 2004; 141(4): 298 - 304. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. L. Lazar Coronary sinus retroperfusion: Can forward progress still be achieved by using a backward technique? J. Thorac. Cardiovasc. Surg., June 1, 2004; 127(6): 1549 - 1552. [Full Text] [PDF]
|
|
|
|
|
|
G. De Luca, N. Ernst, F. Zijlstra, A. W. J. van't Hof, J. C. A. Hoorntje, J.-H. E. Dambrink, A. T. M. Gosslink, M.-J. de Boer, and H. Suryapranata Preprocedural TIMI flow and mortality in patients with acute myocardial infarction treated by primary angioplasty J. Am. Coll. Cardiol., April 21, 2004; 43(8): 1363 - 1367. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. M.G. Legrand, P. W. Serruys, F. Unger, B. A. van Hout, M. C.M. Vrolix, G. M.P. Fransen, T. T. Nielsen, P. K. Paulsen, R. S. Gomes, J. M.G. de Queiroz e Melo, et al. Three-Year Outcome After Coronary Stenting Versus Bypass Surgery for the Treatment of Multivessel Disease Circulation, March 9, 2004; 109(9): 1114 - 1120. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. De Luca, A. W.J. van't Hof, M.-J. de Boer, J. C.A. Hoorntje, A.T. M. Gosselink, J.-H. E. Dambrink, J. P. Ottervanger, F. Zijlstra, and H. Suryapranata Impaired Myocardial Perfusion Is a Major Explanation of the Poor Outcome Observed in Patients Undergoing Primary Angioplasty for ST-Segment-Elevation Myocardial Infarction and Signs of Heart Failure Circulation, March 2, 2004; 109(8): 958 - 961. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. C. Keeley and C. L. Grines Primary Coronary Intervention for Acute Myocardial Infarction JAMA, February 11, 2004; 291(6): 736 - 739. [Full Text] [PDF]
|
|
|
|
|
|
A. Bakhai, G. W. Stone, C. L. Grines, S. A. Murphy, L. Githiora, R. H. Berezin, D. A. Cox, T. Stuckey, J. J. Griffin, J. E. Tcheng, et al. Cost-Effectiveness of Coronary Stenting and Abciximab for Patients With Acute Myocardial Infarction: Results From the CADILLAC (Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications) Trial Circulation, December 9, 2003; 108(23): 2857 - 2863. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Antoniucci, A. Rodriguez, A. Hempel, R. Valenti, A. Migliorini, F. Vigo, G. Parodi, C. Fernandez-Pereira, G. Moschi, A. Bartorelli, et al. A randomized trial comparing primary infarct artery stenting with or without abciximab in acute myocardial infarction J. Am. Coll. Cardiol., December 3, 2003; 42(11): 1879 - 1885. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. R. Le May, R. F. Davies, M. Labinaz, H. Sherrard, J.-F. Marquis, L. A. Laramee, E. R. O'Brien, W. L. Williams, R. S. Beanlands, G. Nichol, et al. Hospitalization Costs of Primary Stenting Versus Thrombolysis in Acute Myocardial Infarction: Cost Analysis of the Canadian STAT Study Circulation, November 25, 2003; 108(21): 2624 - 2630. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. H. Mehta, K. J. Harjai, D. Cox, G. W. Stone, B. Brodie, J. Boura, W. O'Neill, C. L. Grines, and Primary Angioplasty in Myocardial Infarction (PAMI Clinical and angiographic correlates and outcomes of suboptimal coronary flow inpatients with acute myocardial infarction undergoing primary percutaneous coronary intervention J. Am. Coll. Cardiol., November 19, 2003; 42(10): 1739 - 1746. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. A. Cox, G. W. Stone, C. L. Grines, T. Stuckey, D. J. Cohen, J. E. Tcheng, E. Garcia, G. Guagliumi, R. S. Iwaoka, M. Fahy, et al. Outcomes of optimal or "stent-like"balloon angioplasty in acutemyocardial infarction: the CADILLAC trial J. Am. Coll. Cardiol., September 17, 2003; 42(6): 971 - 977. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. De Luca, H. Suryapranata, F. Zijlstra, A. W. J. van't Hof, J. C. A. Hoorntje, A. T. M. Gosselink, J.-H. Dambrink, M.-J. de Boer, and ZWOLLE Myocardial Infarction Study Group Symptom-onset-to-balloon time and mortality in patients with acute myocardial infarction treated by primary angioplasty J. Am. Coll. Cardiol., September 17, 2003; 42(6): 991 - 997. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. J. Moliterno and A. W. Chan Glycoprotein IIb/IIIa inhibition in early intent-to-stent treatment of acute coronary syndromes: EPISTENT, ADMIRAL, CADILLAC, and TARGET J. Am. Coll. Cardiol., February 19, 2003; 41(4_Suppl_S): 49S - 54S. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.-i. Kotani, S. Nanto, G. S. Mintz, M. Kitakaze, T. Ohara, T. Morozumi, S. Nagata, and M. Hori Plaque Gruel of Atheromatous Coronary Lesion May Contribute to the No-Reflow Phenomenon in Patients With Acute Coronary Syndrome Circulation, September 24, 2002; 106(13): 1672 - 1677. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L F Hsu, K H Mak, K W Lau, L L Sim, C Chan, T H Koh, S C Chuah, R Kam, Z P Ding, W S Teo, et al. Clinical outcomes of patients with diabetes mellitus and acute myocardial infarction treated with primary angioplasty or fibrinolysis Heart, September 1, 2002; 88(3): 260 - 265. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M.E. Bertrand and E.P. McFadden Late is perhaps not ... too late for primary PCI in acute myocardial infarction Eur. Heart J., August 1, 2002; 23(15): 1146 - 1148. [Full Text] [PDF]
|
|
|
|
 |
|
 N. J. Goswami, J. M. Moody Jr, and S. R. Bailey Percutaneous Mechanical Reperfusion During Acute Myocardial Infarction J Intensive Care Med, July 1, 2002; 17(4): 162 - 173. [Abstract] [PDF]
|
|
|
|
|
|
M. Singh, H. H. Ting, P. B. Berger, K. N. Garratt, D. R. Holmes Jr, and B. J. Gersh Rationale for on-site cardiac surgery for primary angioplasty: a time for reappraisal J. Am. Coll. Cardiol., June 19, 2002; 39(12): 1881 - 1889. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. W. Stone, C. L. Grines, D. A. Cox, E. Garcia, J. E. Tcheng, J. J. Griffin, G. Guagliumi, T. Stuckey, M. Turco, J. D. Carroll, et al. Comparison of Angioplasty with Stenting, with or without Abciximab, in Acute Myocardial Infarction N. Engl. J. Med., March 28, 2002; 346(13): 957 - 966. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Sasao, A. Endo, T. Hasegawa, Y. Ichikawa, R. Noda, H. Oimatsu, and T. Takada Long-Term Follow-up After Coronary Stent Implantation in Patients with Coronary Artery Disease Angiology, March 1, 2002; 53(2): 149 - 156. [Abstract] [PDF]
|
|
|
|
|
|
C. Loubeyre, M.-C. Morice, T. Lefevre, J.-F. Piechaud, Y. Louvard, and P. Dumas A randomized comparison of direct stenting with conventional stent implantation in selected patients with acute myocardial infarction J. Am. Coll. Cardiol., January 2, 2002; 39(1): 15 - 21. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. E. Buller and R. G. Carere New advances in the management of acute coronary syndromes: 3. The role of catheter-based procedures Can. Med. Assoc. J., January 1, 2002; 166(1): 51 - 61. [Full Text] [PDF]
|
|
|
|
|
|
D. J. Cohen, D. A. Taira, R. Berezin, D. A. Cox, M.-C. Morice, G. W. Stone, and C. L. Grines Cost-Effectiveness of Coronary Stenting in Acute Myocardial Infarction: Results From the Stent Primary Angioplasty in Myocardial Infarction (Stent-PAMI) Trial Circulation, December 18, 2001; 104(25): 3039 - 3045. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Rinfret, C. L. Grines, R. S. Cosgrove, K. K. L. Ho, D. A. Cox, B. R. Brodie, M.-C. Morice, G. W. Stone, D. J. Cohen, and the Stent-PAMI Investigators Quality of life after balloon angioplasty or stenting for acute myocardial infarction: One-year results from the Stent-PAMI trial J. Am. Coll. Cardiol., November 15, 2001; 38(6): 1614 - 1621. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C Loubeyre, T Lefevre, Y Louvard, P Dumas, J.-F Piechaud, J.-J Lanore, J.-F Angellier, J.-Y Le Tarnec, G Karrillon, A Margenet, et al. Outcome after combined reperfusion therapy for acute myocardial infarction, combining pre-hospital thrombolysis with immediate percutaneous coronary intervention and stent Eur. Heart J., July 1, 2001; 22(13): 1128 - 1135. [Abstract] [PDF]
|
|
|
|
|
|
G. Montalescot, P. Barragan, O. Wittenberg, P. Ecollan, S. Elhadad, P. Villain, J.-M. Boulenc, M.-C. Morice, L. Maillard, M. Pansieri, et al. Platelet Glycoprotein IIb/IIIa Inhibition with Coronary Stenting for Acute Myocardial Infarction N. Engl. J. Med., June 21, 2001; 344(25): 1895 - 1903. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. C. Smith Jr, J. T. Dove, A. K. Jacobs, J. Ward Kennedy, D. Kereiakes, M. J. Kern, R. E. Kuntz, J. J. Popma, H. V. Schaff, D. O. Williams, et al. ACC/AHA guidelines for percutaneous coronary intervention (revision of the 1993 PTCA guidelines): A report of the American College of Cardiology/ American Heart Association Task Force on practice guidelines (Committee to revise the 1993 guidelines for percutaneous transluminal coronary angioplasty) endorsed by the Society for Cardiac Angiography and Interventions J. Am. Coll. Cardiol., June 15, 2001; 37(8): 2239 - 2239. [Full Text] [PDF]
|
|
|
|
|
|
R. Zahn, R. Schiele, S. Schneider, A. K. Gitt, H. Wienbergen, K. Seidl, T. Voigtlander, M. Gottwik, G. Berg, E. Altmann, et al. Primary angioplasty versus intravenous thrombolysis in acute myocardial infarction: can we define subgroups of patients benefiting most from primary angioplasty?: Results from the pooled data of the maximal individual therapy in acute myocardial infarction registry and the myocardial infarction registry J. Am. Coll. Cardiol., June 1, 2001; 37(7): 1827 - 1835. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H Suryapranata, J P Ottervanger, E Nibbering, A W J van't Hof, J C A Hoorntje, M J de Boer, M J Al, and F Zijlstra Long term outcome and cost-effectiveness of stenting versus balloon angioplasty for acute myocardial infarction Heart, June 1, 2001; 85(6): 667 - 671. [Abstract] [Full Text]
|
|
|
|
|
|
P. Widimsky Pharmacological versus catheter-based reperfusion: What is present state of the art? Eur. Heart J. Suppl., June 1, 2001; 3(suppl_C): C47 - C54. [Abstract] [PDF]
|
|
|
|
|
|
G. Montalescot, R. Choussat, and J.P. Collet Glycoprotein IIb/IIIa receptors and primary stenting in acute myocardial infarction Eur. Heart J. Suppl., May 1, 2001; 3(suppl_A): A3 - A7. [Abstract] [PDF]
|
|
|
|
|
|
M. R. Le May, M. Labinaz, R. F. Davies, J.-F. Marquis, L. A. Laramee, E. R. O'Brien, W. L. Williams, R. S. Beanlands, G. Nichol, and L. A. Higginson Stenting versus thrombolysis in acute myocardial infarction trial (STAT) J. Am. Coll. Cardiol., March 15, 2001; 37(4): 985 - 991. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Zahn, R. Schiele, S. Schneider, A. K. Gitt, H. Wienbergen, K. Seidl, C. Bossaller, H. J. Buttner, M. Gottwik, E. Altmann, et al. Decreasing hospital mortality between 1994 and 1998 in patients with acute myocardial infarction treated with primary angioplasty but not in patients treated with intravenous thrombolysis: Results from the pooled data of the maximal individual therapy in acute myocardial infarction (MITRA) registry and the myocardial infarction registry (MIR) J. Am. Coll. Cardiol., December 1, 2000; 36(7): 2064 - 2071. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P.J. De Feyter and D. Foley Coronary stent implantation: a panacea for the interventional cardiologist? Eur. Heart J., November 1, 2000; 21(21): 1719 - 1726. [PDF]
|
|
|
|
|
|
H Sasao, K Tsuchihashi, M Hase, T Nakata, K Shimamoto, and t. N.-9. investigators Does primary stenting preserve cardiac function in myocardial infarction? A case-control study Heart, November 1, 2000; 84(5): 515 - 521. [Abstract] [Full Text]
|
|
|
|
|
|
J. Al Suwaidi, P. B. Berger, and D. R. Holmes Jr Coronary Artery Stents JAMA, October 11, 2000; 284(14): 1828 - 1836. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. L. Hannan, M. J. Racz, D. T. Arani, B. D. McCallister, G. Walford, and T. J. Ryan A comparison of short- and long-term outcomes for balloon angioplasty and coronary stent placement J. Am. Coll. Cardiol., August 1, 2000; 36(2): 395 - 403. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Maillard, M. Hamon, K. Khalife, P. G. Steg, F. Beygui, J.-L. Guermonprez, C. M. Spaulding, J.-M. Boulenc, J. Lipiecki, A. Lafont, et al. A comparison of systematic stenting and conventional balloon angioplasty during primary percutaneous transluminal coronary angioplasty for acute myocardial infarction J. Am. Coll. Cardiol., June 1, 2000; 35(7): 1729 - 1736. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. W. ROBERTS and S. W. REDDING CORONARY ARTERY STENTS: REVIEW AND PATIENT-MANAGEMENT RECOMMENDATIONS J Am Dent Assoc, June 1, 2000; 131(6): 797 - 801. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. M. Hoffman, L. Allen, M. J. Baumel, F. Alfonso, and C. L. Grines Coronary-Artery Stenting in Acute Myocardial Infarction N. Engl. J. Med., May 11, 2000; 342(19): 1447 - 1448. [Full Text]
|
|
|
|
|
|
F.-J. Neumann, A. Kastrati, C. Schmitt, R. Blasini, M. Hadamitzky, J. Mehilli, M. Gawaz, M. Schleef, M. Seyfarth, J. Dirschinger, et al. Effect of glycoprotein IIb/IIIa receptor blockade with abciximab on clinical and angiographic restenosis rate after the placement of coronary stents following acute myocardial infarction J. Am. Coll. Cardiol., March 15, 2000; 35(4): 915 - 921. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Tackling myocardial infarction DTB, March 1, 2000; 38(3): 17 - 22. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K.-H. Mak and E. J. Topol Emerging concepts in the management of acute myocardial infarction in patients with diabetes mellitus J. Am. Coll. Cardiol., March 1, 2000; 35(3): 563 - 568. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. L. Grines, D. A. Cox, G. W. Stone, E. Garcia, L. A. Mattos, A. Giambartolomei, B. R. Brodie, O. Madonna, M. Eijgelshoven, A. J. Lansky, et al. Coronary Angioplasty with or without Stent Implantation for Acute Myocardial Infarction N. Engl. J. Med., December 23, 1999; 341(26): 1949 - 1956. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Zijlstra, J. C.A. Hoorntje, M.-J. de Boer, S. Reiffers, K. Miedema, J. P. Ottervanger, A. W.J. van 't Hof, and H. Suryapranata Long-Term Benefit of Primary Angioplasty as Compared with Thrombolytic Therapy for Acute Myocardial Infarction N. Engl. J. Med., November 4, 1999; 341(19): 1413 - 1419. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. P. Faxon and J. W. Heger Primary Angioplasty -- Enduring the Test of Time N. Engl. J. Med., November 4, 1999; 341(19): 1464 - 1465. [Full Text]
|
|
|
|
|
|
I. Herz, A. Assali, A. Solodky, N. Shor, T. Ben-Gal, Y. Adler, and Y. Birnbaum Coronary Stent Deployment Without Predilation in Acute Myocardial Infarction: A Feasible, Safe, and Effective Technique Angiology, November 1, 1999; 50(11): 901 - 908. [Abstract] [PDF]
|
|
|
|
|
|
S BRENER and E J TOPOL Logic and logistics: conundrum in reperfusion treatment for acute myocardial infarction Heart, October 1, 1999; 82(4): 402 - 403. [Full Text] [PDF]
|
|
|
|
|
|
T. J. Ryan, E. M. Antman, N. H. Brooks, R. M. Califf, L. D. Hillis, L. F. Hiratzka, E. Rapaport, B. Riegel, R. O. Russell, E. E. Smith III, et al. 1999 update: 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 (Committee on Management of Acute Myocardial Infarction) J. Am. Coll. Cardiol., September 1, 1999; 34(3): 890 - 911. [Full Text] [PDF]
|
|
|
|
|
|
N. Danchin, L. Vaur, N. Genes, S. Etienne, M. Angioi, J. Ferrieres, and J.-P. Cambou Treatment of Acute Myocardial Infarction by Primary Coronary Angioplasty or Intravenous Thrombolysis in the "Real World" : One-Year Results From a Nationwide French Survey Circulation, May 25, 1999; 99(20): 2639 - 2644. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. M. Gibson Primary Angioplasty Compared with Thrombolysis: New Issues in the Era of Glycoprotein IIb/IIIa Inhibition and Intracoronary Stenting Ann Intern Med, May 18, 1999; 130(10): 841 - 847. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. J. Scanlon, D. P. Faxon, A.-M. Audet, B. Carabello, G. J. Dehmer, K. A. Eagle, R. D. Legako, D. F. Leon, J. A. Murray, S. E. Nissen, et al. ACC/AHA guidelines for coronary angiography: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Coronary Angiography) developed in collaboration with the Society for Cardiac Angiography and Interventions J. Am. Coll. Cardiol., May 1, 1999; 33(6): 1756 - 1824. [Full Text] [PDF]
|
|
|
|
|
|
G. W. Stone, B. R. Brodie, J. J. Griffin, C. Costantini, M. C. Morice, F. G. St. Goar, P. A. Overlie, J. J. Popma, J. McDonnell, D. Jones, et al. Clinical and Angiographic Follow-Up After Primary Stenting in Acute Myocardial Infarction : The Primary Angioplasty in Myocardial Infarction (PAMI) Stent Pilot Trial Circulation, March 30, 1999; 99(12): 1548 - 1554. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F.-J. Neumann, R. Blasini, C. Schmitt, E. Alt, J. Dirschinger, M. Gawaz, A. Kastrati, and A. Schomig Effect of Glycoprotein IIb/IIIa Receptor Blockade on Recovery of Coronary Flow and Left Ventricular Function After the Placement of Coronary-Artery Stents in Acute Myocardial Infarction Circulation, December 15, 1998; 98(24): 2695 - 2701. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Stenting vs. Angioplasty for Acute MI: A Promising Small Trial Journal Watch (General), July 10, 1998; 1998(710): 5 - 5. [Full Text]
|
|
|
|
|
|
G. W. Stone Primary Stenting in Acute Myocardial Infarction : The Promise and the Proof Circulation, June 30, 1998; 97(25): 2482 - 2485. [Full Text] [PDF]
|
|
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||