Abstract:
BACKGROUND:Percutaneous transluminal coronary angioplasty of the infarct-related artery in stable survivors of acute myocardial infarction is often performed, even in patients without any symptoms or residual ischemia. Despite the lack of randomized studies, it is widely believed that this intervention will improve the clinical outcome of these patients. METHODS AND RESULTS:Three hundred patients with single vessel disease of the infarct vessel and no or minor angina pectoris in the subacute phase (1 to 6 weeks) after an acute myocardial infarction were randomized to angioplasty (n=149) or medical therapy (n=151). Primary end point was the survival free of reinfarction, (re)intervention, coronary artery bypass surgery, or readmission for severe angina pectoris at 1 year. The event-free survival at 1 year was 82% in the medical group and 90% in the angioplasty group (P=0.06). This difference was mainly driven by the difference in the need for (re)interventions (20 versus 8, P=0.03). At long-term follow-up (mean, 56 months), survival was 89% and 96% (P=0.02). Survival free of reinfarction, (re)intervention, or coronary artery bypass surgery was 66% and 80% in the medically and interventionally treated patients, respectively (P=0.05). The use of nitrates was significantly lower in the angioplasty group, both at 1 year (38% versus 67%, P=0.001) and at long-term follow-up (36% versus 55%, P=0.006). CONCLUSIONS:Percutaneous revascularization of the infarct-related coronary artery in stable patients with single vessel disease improves clinical outcome at long-term follow-up and reduces the use of nitrates. The results of our study should be reproduced in a confirmatory study with a larger sample size before percutaneous coronary intervention in this low-risk patient subgroup, after myocardial infarction can be recommended as routine treatment in clinical practice.
journal_name
Circulationjournal_title
Circulationauthors
Zeymer U,Uebis R,Vogt A,Glunz HG,Vöhringer HF,Harmjanz D,Neuhaus KL,ALKK-Study Group.doi
10.1161/01.CIR.0000087605.09362.0Esubject
Has Abstractpub_date
2003-09-16 00:00:00pages
1324-8issue
11eissn
0009-7322issn
1524-4539pii
01.CIR.0000087605.09362.0Ejournal_volume
108pub_type
临床试验,杂志文章,多中心研究,随机对照试验相关文献
CIRCULATION文献大全abstract::Spontaneous coronary artery dissection (SCAD) has emerged as an important cause of acute coronary syndrome, myocardial infarction, and sudden death, particularly among young women and individuals with few conventional atherosclerotic risk factors. Patient-initiated research has spurred increased awareness of SCAD, and...
journal_title:Circulation
pub_type: 杂志文章,实务指引,评审
doi:10.1161/CIR.0000000000000564
更新日期:2018-05-08 00:00:00
abstract:BACKGROUND:The TAXUS NIRx stent (Boston Scientific Corp) provides local delivery of paclitaxel via a slow-release polymer coating. The TAXUS I trial was the first in-human experience evaluating safety and feasibility of the TAXUS NIRx stent system compared with bare NIR stents (control) (Boston Scientific Corp) for tre...
journal_title:Circulation
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1161/01.cir.0000047700.58683.a1
更新日期:2003-01-07 00:00:00
abstract:BACKGROUND:Circulatory arrest (CA), which provides a bloodless field and good visualization without the need of aortic cross-clamp, is commonly used to facilitate repair of aortic lesions. However, extended periods of CA may impair cerebral metabolism and cause ischemic injury. Studies were performed to evaluate the ef...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1996-11-01 00:00:00
abstract:BACKGROUND:The mainstay of treatment for atrial fibrillation (AF) remains pharmacological; however, catheter ablation has increasingly been used over the last decade. The relative merits of each strategy have not been extensively studied. METHODS AND RESULTS:We conducted a randomized multicenter comparison of these 2 ...
journal_title:Circulation
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1161/CIRCULATIONAHA.108.772582
更新日期:2008-12-09 00:00:00
abstract:BACKGROUND:We explored whether chronic hyperglycemia is associated with defects in endothelium-dependent vasodilatation in vivo and whether defects in the hemodynamic effects of insulin explain insulin resistance. METHODS AND RESULTS:Vasodilator responses to brachial artery infusions of acetylcholine, sodium nitroprus...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.94.6.1276
更新日期:1996-09-15 00:00:00
abstract:BACKGROUND:Although gender-specific criteria are common for defining cardiac traits such as left ventricular hypertrophy, left ventricular ejection fraction (LVEF) thresholds widely used in clinical practice have traditionally been the same for women and men, perhaps because it remains uncertain whether there is a syst...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.105.574400
更新日期:2006-03-28 00:00:00
abstract:BACKGROUND:Hypertrophic cardiomyopathy (HCM) is characterized by myocardial hypertrophy of unknown etiology. Missense mutations of the cardiac beta-myosin-heavy-chain (beta-MHC) gene that may be responsible for cardiac hypertrophy have been detected in patients with HCM. On the other hand, gross structural abnormalitie...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.91.12.2911
更新日期:1995-06-15 00:00:00
abstract:BACKGROUND:Glycoprotein (GP) IIb/IIIa inhibitors are beneficial in patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS); their safe use in women, however, remains a concern. The contribution of dosing to the observed sex-related differences in bleeding is unknown. METHODS AND RESULTS:We explored ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.106.620815
更新日期:2006-09-26 00:00:00
abstract::To assess the effects on the heart itself of coronary thrombolysis induced with either tissue-type plasminogen activator (t-PA) or streptokinase (SK), we performed positron emission tomography with 11C-palmitate in 19 patients with initial transmural myocardial infarction immediately after admission and again within 4...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.69.5.983
更新日期:1984-05-01 00:00:00
abstract::Patients with idiopathic hypertrophic subaortic stenosis (IHSS) have supernormal left ventricular systolic function at rest. Septal myotomy/myectomy reduces outflow obstruction and symptoms. However, it has been proposed that operation causes myocardial damage, with consequent reduction in left ventricular function an...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.60.2.82
更新日期:1979-08-01 00:00:00
abstract:BACKGROUND:Recently, it was shown that intraindividual variation in low-density lipoprotein cholesterol (LDL-C) predicts both cerebrovascular and cardiovascular events. We aimed to examine whether this extends to cognitive function and examined possible pathways using a magnetic resonance imaging substudy. METHODS:We ...
journal_title:Circulation
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1161/CIRCULATIONAHA.115.020627
更新日期:2016-07-19 00:00:00
abstract::The first stage of a repair of pulmonary atresia with intact ventricular septum (type I) was attempted in a 2-day-old infant. At surgery, decompression of the hypertensive small right ventricle was followed by a sudden loss of myocardial contractility and death. Postmortem examination revealed a fistula with a large o...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.65.4.805
更新日期:1982-04-01 00:00:00
abstract::A case of progressive pulmonary hypertension in a child with a small ventricular septal defect is presented. Natural history studies have indicated that children with small ventricular septal defects can be followed conservatively. This case represents a contradiction to that rule and suggests that further study must ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.67.2.470
更新日期:1983-02-01 00:00:00
abstract:BACKGROUND:The optimal strategy for treating coronary bifurcation lesions remains a subject of debate. With bare-metal stents, single-stent approaches appear to be superior to systematic 2-stent strategies. Drug-eluting stents, however, have low rates of restenosis and might offer improved outcomes with complex stentin...
journal_title:Circulation
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1161/CIRCULATIONAHA.109.888297
更新日期:2010-03-16 00:00:00
abstract:BACKGROUND:A variety of transcatheter atrial septal defect (ASD) occluders are currently in use around the world. Although for the most part effective, all of these devices lack features that would be desirable in a "perfect" device. The Helex septal occluder is a new type of device designed to improve the results of t...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/hc3301.092792
更新日期:2001-08-07 00:00:00
abstract:BACKGROUND:Calcineurin is a calcium-regulated phosphatase that plays a major role in cardiac hypertrophy. We previously described that alternative splicing of the calcineurin Aβ (CnAβ) gene generates the CnAβ1 isoform, with a unique C-terminal region that is different from the autoinhibitory domain present in all other...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.110.012211
更新日期:2011-06-21 00:00:00
abstract::The left anterior descending coronary artery of four dogs and the right common carotid artery of 15 rabbits were subjected to 40-60% reduction in transluminal diameter for 1 hour by partial ligation with suture thread. Scanning electron microscopic examination of the luminal surface of these vessels revealed endotheli...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.63.3.476
更新日期:1981-03-01 00:00:00
abstract::Three hundred consecutive patients who developed unstable postinfarction angina requiring isolated coronary artery bypass from 1982 through 1987 were analyzed. Hospital mortality was 5%; 15 (5.5%) additional late deaths occurred during the 69-month follow-up period (mean follow-up, 23.3 months). Significant independen...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1989-06-01 00:00:00
abstract::Experimental studies demonstrate that short-term regional perfusion-contraction matching, in which the energy demands of regional myocardial contraction are reduced to match the diminished myocardial substrate supply, occurs during states of low coronary blood flow under resting conditions and during exercise-induced ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.83.3.1076
更新日期:1991-03-01 00:00:00
abstract:BACKGROUND:High-mobility group box-1 (HMGB1) is a nuclear factor released by necrotic cells and by activated immune cells. HMGB1 signals via members of the toll-like receptor family and the receptor for advanced glycation end products (RAGE). Although HMGB1 has been implicated in ischemia/reperfusion (I/R) injury of th...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.108.769331
更新日期:2008-06-24 00:00:00
abstract::Although exercise ECG testing has been shown to have important prognostic value after acute myocardial infarction, exercise 201Tl scintigraphy offers several potential advantages, including: 1) increased sensitivity for detecting residual myocardial ischemia; 2) the ability to localize ischemia to a specific area or a...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1991-09-01 00:00:00
abstract:BACKGROUND:Hypercholesterolemic mice lacking factors required for activation of CD4+ T cells are characterized by reduced development of atherosclerosis. Consequently, it has been assumed that atherosclerosis involves loss of tolerance against modified self-antigens generated in response to hypercholesterolemia and tha...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.118.039288
更新日期:2019-05-28 00:00:00
abstract:BACKGROUND:The atrioventricular (AV) node is insensitive to changes in extracellular potassium concentration, [K+]o, because of the absence of the inward rectifier potassium current (IK1). However, we propose that in the presence of adenosine, elevated [K+]o should increase the adenosine-activated inward rectifier pota...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.99.2.312
更新日期:1999-01-19 00:00:00
abstract:BACKGROUND:We reviewed the outcome of 76 consecutive patients (age range, 5 months to 6 years; median age, 19 months) who underwent a modified Fontan procedure after initial palliative surgery for hypoplastic left heart syndrome (HLHS) between January 1984 and December 1989. METHODS AND RESULTS:Modifications of the Fo...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.85.1.116
更新日期:1992-01-01 00:00:00
abstract::The coronavirus disease 2019 (COVID-19) pandemic has affected health and economy worldwide on an unprecedented scale. Patients have diverse clinical outcomes, but those with preexisting cardiovascular disease, hypertension, and related conditions incur disproportionately worse outcome. The high infectivity of severe a...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.120.047549
更新日期:2020-07-07 00:00:00
abstract::To determine whether real-time two-dimensional echocardiography (2-D echo) can estimate the extent of myocardial involvement in patients with acute myocardial infarction (MI), regional wall motion on serial short-axis 2-D echo recordings was analyzed and the summed scores were compared with estimates of infarct involv...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.62.6.1248
更新日期:1980-12-01 00:00:00
abstract::For half a century the systolic click and late systolic murmur lay dormant as innocent auscultatory curiosities. The thirteen years since Barlow related these phenomena to mitral leaflet prolapse have witnessed an astonishing information explosion. We have sought to bring together the accumulated data in this review. ...
journal_title:Circulation
pub_type: 杂志文章,评审
doi:10.1161/01.cir.54.1.3
更新日期:1976-07-01 00:00:00
abstract::In this study we extended the characterization of outcome in 1214 medically treated patients with coronary disease by considering nonfatal infarction and death together as ischemic events. At 7 years, the cumulative event rate was 47% (18% for nonfatal infarction as the initial event and 29% for death as the initial e...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.62.4.718
更新日期:1980-10-01 00:00:00
abstract:BACKGROUND:The effect of effective refractory period (ERP) shortening on the vulnerability and characteristics of induced functional reentry in the ventricle remain poorly defined. We hypothesized that ERP shortening increases ventricular vulnerability to reentry and accelerates its rate, as is the case in the atrium. ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.99.5.704
更新日期:1999-02-09 00:00:00
abstract:BACKGROUND:The number of CD4(+)CD28(null) (CD28(null)) T cells, a unique subset of T lymphocytes with proinflammatory and cell-lytic phenotype, increases markedly in patients with acute coronary syndrome (ACS). ACS patients harboring high numbers of CD28(null) T cells have increased risk of recurrent severe acute coron...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.114.013710
更新日期:2015-02-24 00:00:00