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dc.contributor.authorCzarnecki, Andrew
dc.contributor.authorWelsh, Robert C.
dc.contributor.authorYan, Raymond T.
dc.contributor.authorDeYoung, J. Paul
dc.contributor.authorGallo, Richard
dc.contributor.authorRose, Barry
dc.contributor.authorGrondin, Francois R.
dc.contributor.authorKornder, Jan
dc.contributor.authorWong, Graham C.
dc.contributor.authorFox, Keith A. A.
dc.contributor.authorGore, Joel M.
dc.contributor.authorGoodman, Shaun G.
dc.contributor.authorYan, Andrew T.
dc.date2022-08-11T08:08:09.000
dc.date.accessioned2022-08-23T15:44:16Z
dc.date.available2022-08-23T15:44:16Z
dc.date.issued2012-01-02
dc.date.submitted2012-02-02
dc.identifier.citationCan J Cardiol. 2012 Jan;28(1):40-7. Epub 2011 Nov 29. <a href="http://dx.doi.org/10.1016/j.cjca.2011.09.011">Link to article on publisher's site</a>
dc.identifier.issn0828-282X (Linking)
dc.identifier.doi10.1016/j.cjca.2011.09.011
dc.identifier.pmid22129488
dc.identifier.urihttp://hdl.handle.net/20.500.14038/27280
dc.description.abstractBACKGROUND: We examine the clinical characteristics and outcomes of ST-elevation myocardial infarction (STEMI) patients receiving various reperfusion therapies in 2 contemporary Canadian registries. METHODS: Of 4045 STEMI patients, 2024 received reperfusion therapy and had complete data on invasive management. They were stratified by reperfusion strategy used: primary percutaneous coronary intervention (PCI) (n =716); fibrinolysis with rescue PCI (n =177); fibrinolysis with urgent/elective PCI (n =210); and fibrinolysis without PCI (n =921). Data were collected on clinical and laboratory findings, and outcomes. RESULTS: Compared with fibrinolytic-treated patients, patients treated with primary PCI were younger and had higher Killip class, had longer time to delivery of reperfusion therapy, and utilized more antiplatelet therapy but less heparin, beta-blockers and angiotensin-converting enzyme inhibitors. In-hospital death occurred in 2.7% of patients treated with primary PCI, 1.7% fibrinolysis-rescue PCI, 1.0% fibrinolysis-urgent/elective PCI, and 4.8% fibrinolysis-alone (P =0.009); the rates of death/reinfarction were 3.9%, 4.0%, 4.3%, and 7.1% (P =0.032), respectively. The rate of shock was highest in the primary PCI group. Rates of heart failure or major bleeding were similar in the 4 groups. In multivariable analysis, no PCI during hospitalization was associated with death and reinfarction (adjusted odds ratio = 1.66; 95% confidence interval, 1.03-2.70; P =0.04). CONCLUSIONS: Clinical features, time to reperfusion, and medication utilization differed with respect to the reperfusion strategy. While low rates of re-infarction/death were observed, these complications occurred more frequently in those who did not undergo PCI during index hospitalization. Inc. All rights reserved.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=22129488&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1016/j.cjca.2011.09.011
dc.subjectMyocardial Infarction
dc.subjectMyocardial Reperfusion
dc.subjectHealth Services Research
dc.titleReperfusion Strategies and Outcomes of ST-Segment Elevation Myocardial Infarction Patients in Canada: Observations From the Global Registry of Acute Coronary Events (GRACE) and the Canadian Registry of Acute Coronary Events (CANRACE)
dc.typeJournal Article
dc.source.journaltitleThe Canadian journal of cardiology
dc.source.volume28
dc.source.issue1
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/cor_grace/97
dc.identifier.contextkey2490923
html.description.abstract<p>BACKGROUND: We examine the clinical characteristics and outcomes of ST-elevation myocardial infarction (STEMI) patients receiving various reperfusion therapies in 2 contemporary Canadian registries.</p> <p>METHODS: Of 4045 STEMI patients, 2024 received reperfusion therapy and had complete data on invasive management. They were stratified by reperfusion strategy used: primary percutaneous coronary intervention (PCI) (n =716); fibrinolysis with rescue PCI (n =177); fibrinolysis with urgent/elective PCI (n =210); and fibrinolysis without PCI (n =921). Data were collected on clinical and laboratory findings, and outcomes.</p> <p>RESULTS: Compared with fibrinolytic-treated patients, patients treated with primary PCI were younger and had higher Killip class, had longer time to delivery of reperfusion therapy, and utilized more antiplatelet therapy but less heparin, beta-blockers and angiotensin-converting enzyme inhibitors. In-hospital death occurred in 2.7% of patients treated with primary PCI, 1.7% fibrinolysis-rescue PCI, 1.0% fibrinolysis-urgent/elective PCI, and 4.8% fibrinolysis-alone (P =0.009); the rates of death/reinfarction were 3.9%, 4.0%, 4.3%, and 7.1% (P =0.032), respectively. The rate of shock was highest in the primary PCI group. Rates of heart failure or major bleeding were similar in the 4 groups. In multivariable analysis, no PCI during hospitalization was associated with death and reinfarction (adjusted odds ratio = 1.66; 95% confidence interval, 1.03-2.70; P =0.04).</p> <p>CONCLUSIONS: Clinical features, time to reperfusion, and medication utilization differed with respect to the reperfusion strategy. While low rates of re-infarction/death were observed, these complications occurred more frequently in those who did not undergo PCI during index hospitalization. Inc. All rights reserved.</p>
dc.identifier.submissionpathcor_grace/97
dc.contributor.departmentDepartment of Medicine, Division of Cardiovascular Medicine
dc.contributor.departmentCenter for Outcomes Research
dc.source.pages40-7


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