检索结果-南通市图书馆

Thorombolytic therapy with rescue percutaneous coronary intervention versus primary percutaneous coronary intervention in patients with acute myocardial infarction： a multicenter randomized clinical trial

引用

Chinese Medical Journal 2010年第11期123卷 1365-1372页

作者： GAO Run-lin HAN Ya-ling YANG Xin-chun MAO Jie-ming FANG Wei-yi WANG Lei SHEN Wei-feng LI Zhan-quan JIA Guo-liang LU Shu-zheng WEI Meng ZENG Ding-yin CHEN Ji-lin QIN Xue-wen XU Bo DU Chang-hui Department of Cardiology Cardiovascular Institute & Fu WaiHospital Chinese Academy of Medical Sciences Beijing 100037China Department of Cardiology Shenyang Northern HospitalShenyang Liaoning 110840 China Depal-tment of Cardiology Beijing Chaoyang Hospital Beijing100020 China Department of Cardiology Peking University Third HospitalBeijing 100083 China Department of Cardiology First Affiliated Hospital of DalianMedical University Dalian Liaoning 116011 China Department of Cardiology Beijing Friendship Hospital Beijing100050 China Department of Cardiology Ruijin Hospital Shanghai Jiao TongUniversity School of Medicine Shanghai 200025 China Department of Cardiology Liaoning Provincial People's HospitalShenyang Liaoning 110016 China Department of Cardiology Xijing Hospital Forth Military MedicalUniversity Xi'an Shaanxi 710032 China Department of Cardiology Beijing Anzhen Hospital CapitalMedical University Beijing 100029.C.hina Department of Cardiology Shanghai sixth People's HospitalShanghai 200233 China Western China Public Health Institute Sichuan UniversityChengdu Sichuan 610041 China

Background Although thrombolytic therapy with rescue percutaneous coronary intervention （PCI） is a common treatment strategy for ST-segment elevation acute myocardial infarction （STEMI）, scant data are available on its efficacy relative to primary PCI, and comparison was therefore the aim of this study. Methods This multicenter, open-label, randomized, parallel trial was conducted in 12 hospitals on patients （age 〈70 years） with STEMI who presented within 12 hours of symptom onset （mean interval 〉3 hours）. Patients were randomized to three groups： primary PCI group （n=101）; recombinant staphylokinase （r-Sak） group （n=-104）; and recombinant tissue-type plasminogen activator （rt-PA） group （n=-106）. For all patients allocated to the thrombolytic therapy arm, coronary angiography was performed at 90 minutes after drug therapy to confirm infarct-related artery （IRA） patency; rescue PCI was performed in cases with TIMI flow grade 〈2. Bare-metal stent implantation was planned for all patients. Results After randomization it required an average of 113.4 minutes to start thrombolytic therapy （door-to-needle time）and 141.2 minutes to perform first balloon inflation in the IRA （door to balloon time）. Rates of IRA patency （TIMI flow grade 2 or 3） and TIMI flow grade 3 were significantly lower in the thrombolysis group at 90 minutes after drug therapy than in the primary PCI group at the end of the procedure （70.5% vs. 98.0%, P 〈0.0001, and 53.0% vs. 85.9%, P 〈0.0001, respectively）. rescue PCI with stenting was performed in 117 patients （55.7%） in the thrombolytic therapy arm. Rates of patency and TIMI flow grade 3 were still significantly lower in the rescue PCI than in the primary PCI group （88.9% vs. 97.9%, P=-0.0222, and 68.4% vs. 85.0%, P=0.0190, respectively）. At 30 days post-therapy, mortality rate was significantly higher in the thrombolysis combined with rescue PCI group than in primary PCI group （7.1% vs. 0, P=0.0034）. Rates of death/MI and bleeding complications were significantly higher in the thrombolysis with re

关键词： acute myocardial infarction thorombolytic therapy rescue percutaneous coronary intervention primary percutaneous coronary intervention

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：