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Published on: April 25, 2014
Short- and long-term mortality for patients undergoing primary angioplasty for acute myocardial infarction
E L Hannan1, M J Racz, D T Arani
1State University of New York, University at Albany, USA.
Insights
Primary angioplasty is a highly effective treatment for acute myocardial infarction (AMI). Excluding patients in shock, in-hospital mortality was low, with favorable long-term survival rates.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
Background:
- Primary angioplasty is an effective alternative to thrombolytic therapy for acute myocardial infarction (AMI).
- Previous studies on primary angioplasty often suffered from small sample sizes and limited follow-up periods.
Purpose of the Study:
- To investigate risk factors and short- and long-term outcomes of primary angioplasty for acute myocardial infarction (AMI).
Main Methods:
- Utilized data from New York's coronary angioplasty registry (1993-1996) for patients undergoing angioplasty within 6 hours of AMI.
- Employed statistical models to identify survival risk factors and estimate long-term survival rates.
Main Results:
- In-hospital mortality for all primary angioplasty patients was 5.81%, decreasing to 2.60% when patients in preprocedural shock were excluded.
- One, two, and three-year mortality rates were 9.3%, 11.3%, and 12.6%, respectively.
- Stent placement did not significantly reduce risk-adjusted in-patient or two-year mortality.
Conclusions:
- Primary angioplasty is a highly effective treatment strategy for patients with acute myocardial infarction (AMI).
Objectives:
The goal of this study was to learn more about the risk factors and short- and long-term outcomes for primary angioplasty.
Background:
Primary angioplasty (direct angioplasty without antecedent thrombolytic therapy) has been an effective alternative to thrombolytic therapy for patients with acute myocardial infarction (AMI). However, most reported studies have been compromised by small sample sizes and short observation times.
Methods:
New York's coronary angioplasty registry was used to identify New York patients undergoing angioplasty within 6 h of AMI between January 1, 1993 and December 31, 1996. Statistical models were used to identify significant risk factors for in-patient and long-term survival and to estimate long-term survival for all patients as well as various subsets of patients undergoing primary angioplasty.
Results:
The in-hospital mortality rate for all primary angioplasty patients was 5.81%. When patients in preprocedural shock (who had a mortality rate of 45%) were excluded, the in-hospital mortality rate dropped to 2.60%. Mortality rates for all primary angioplasty patients at one year, two years and three years were 9.3%, 11.3% and 12.6%, respectively. Patients treated with stent placement did not have significantly lower risk-adjusted in-patient or two-year mortality rates.
Conclusions:
Primary angioplasty is a highly effective option for AMI.
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