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Temporal changes in the current practice of primary angioplasty: a real life experience of a single high-volume center
- Source :
- Cardiovascular Revascularization Medicine. 17:5-9
- Publication Year :
- 2016
- Publisher :
- Elsevier BV, 2016.
-
Abstract
- In the last years, new techniques, drugs and devices have been introduced in the current practice of primary angioplasty (PPCI) and validated by pivotal studies The objective of our study was to evaluate if these studies have led to significant changes on the current practice of primary PCI in our center.From March 2003 to December 2013 1980 patients with ST-segment elevation myocardial infarction underwent PPCI within 12-hours of onset of symptoms. We considered 2 periods of our activity: from 2003 to 2009 (P1) with 1078 patients and from 2010 to 2013 (P2) with 902 patients, and compared them in terms of pharmacological and arterial access strategies and of devices utilization.In P2 there was a significant increase of radial access (34.1% vs. 1.5, p0.001), as well as of the use of bivalirudin (22.7% vs. 0.5%, p0.001) and of new antiplatelet drugs (prasugrel or ticagrelor) (18.3% vs. 0%, p0.001) whereas the use of GP IIb-IIIa and of intraaortic balloon pump significantly decreased (from 82.3% to 52%, p0.001 and from 17% to 7.5%, p0.001 respectively). In the P2 there was a significant increase of the procedural efficacy (97.2% vs. 95.1%, p=0.01) that persisted after the logistic regression adjustment (OR 2.09, CI 95%, 1.04-4.21).Our study shows that in the last years, in a high-PCI center, after the publication of pivotal randomized trial and nationwide registries, there were significant changes in the PPCI current practice that could have had an impact on procedural efficacy.
- Subjects :
- Male
Temporal changes of primary angioplasty
medicine.medical_specialty
Primary angioplasty
Acute myocardial infarction
030204 cardiovascular system & hematology
Antithrombins
law.invention
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
law
Humans
Medicine
Registries
030212 general & internal medicine
Myocardial infarction
Acute Coronary Syndrome
Aged
business.industry
Angioplasty
General Medicine
Hirudins
Middle Aged
medicine.disease
Peptide Fragments
Recombinant Proteins
Treatment Outcome
Italy
Current practice
Conventional PCI
High volume center
Emergency medicine
Female
Cardiology and Cardiovascular Medicine
business
Platelet Aggregation Inhibitors
Subjects
Details
- ISSN :
- 15538389
- Volume :
- 17
- Database :
- OpenAIRE
- Journal :
- Cardiovascular Revascularization Medicine
- Accession number :
- edsair.doi.dedup.....379a70e6597c31ffa41f82fba8579649