Abstract:
:The exact relationship between primary percutaneous coronary intervention (PCI) volume and mortality remains unclear. No data are available on how this relationship could be affected by time-to-presentation. The primary aim of this study was to evaluate the impact of hospital primary PCI volume on in-hospital mortality in ST-elevation myocardial infarction (STEMI) patients depending on time-to-presentation. The impact of primary PCI volume on in-hospital mortality was investigated in a prospective registry of the Lombardy region in Northern Italy, deriving data on mortality rates and number of primary PCIs from a cohort of 2,558 patients. We also explored this relationship at different times-to-presentation (≤90 min, >90 min-180 min, >180 min) and risk profiles assessed with the TIMI Risk Index. A strong inverse relationship was found between primary PCI hospital volume and risk-adjusted mortality (r = -0.9; P < 0.001). High primary PCI volumes best predicted the improvement of survival when the time-to-presentation was ≤90 min (area under the curve = 0.73, P < 0.0001). At this time, the best primary PCI threshold to provide benefit was >66 primary PCIs/year (OR = 0.21 [95% CI 0.10-0.47], P < 0.001) and those with high TIMI Risk Index achieved the greatest benefit (P < 0.001). At >90 min-180 min, the model was less significant (P = 0.02) with a higher threshold of procedures (>145 primary PCIs/year) required to provide benefits. The model was not predictive of survival for time-to-presentation >180 min (P = 0.30). The reduction of mortality of STEMI patients treated at high-volume primary PCI centers is time-dependent and affected by risk profile. The greatest benefit was observed in high-risk patients presenting within 90 min from symptoms onset.
journal_name
J Thromb Thrombolysisjournal_title
Journal of thrombosis and thrombolysisauthors
Navarese EP,De Servi S,Politi A,Martinoni A,Musumeci G,Boschetti E,Belli G,D'Urbano M,Piccaluga E,Lettieri C,Klugmann Sdoi
10.1007/s11239-011-0598-1subject
Has Abstractpub_date
2011-08-01 00:00:00pages
223-31issue
2eissn
0929-5305issn
1573-742Xjournal_volume
32pub_type
临床试验,杂志文章,多中心研究abstract::It has been reported that platelet expression and plasma levels of soluble P-selectin are increased in patients with unstable coronary artery syndromes. However, the origin of soluble P-selectin remains unknown. We sought to determine whether platelet expression of P-selectin correlates with plasma levels in the popul...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1023/a:1018738502654
更新日期:2000-08-01 00:00:00
abstract::Amlodipine, commonly used for relief of ischemic symptoms in coronary artery disease (CAD), may affect clopidogrel-induced antiplatelet effects. It remains unknown if ranolazine, an antianginal drug that constitutes a pharmacologic alternative to calcium channel blockade, interferes with clopidogrel-induced antiplatel...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1007/s11239-015-1203-9
更新日期:2015-10-01 00:00:00
abstract::Patients with non-valvular atrial fibrillation who are under chronic oral anticoagulant therapy (OAC) treatment frequently require interruption of OAC treatment. By examining the presence of left atrial/left atrial appendage (LA/LAA) thrombus or dense spontaneous echo contrast (SEC) with transesophageal echocardiograp...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-020-02104-9
更新日期:2020-08-01 00:00:00
abstract::Hyperhomocysteinemia (HHcy) affects haemostasis and shifts its balance in favour of thrombosis. In vitro and in vivo studies suggested that HHcy may impair fibrinolysis either by influencing the plasma levels of fibrinolytic factors or by altering the fibrinogen structure. We investigated the influence of mild HHcy le...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 临床试验,杂志文章
doi:10.1007/s11239-013-0981-1
更新日期:2014-07-01 00:00:00
abstract::Coronary artery fistulae (CAF) are rare congenital or acquired in which a connection forms between one of the coronary arteries and a heart chamber or with other vessels. This paper describes three cases of CAF along with their initial presentation, imaging findings and management. The first case is a rare form of CAF...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,评审
doi:10.1007/s11239-019-01897-8
更新日期:2019-08-01 00:00:00
abstract::Management of intermediate and high risk acute pulmonary embolism (PE) is challenging. The role of multidisciplinary teams for the care of these patients is emerging. Herein, we report our experience with a pulmonary embolism response team (PERT). We conducted a retrospective chart review on all patients admitted to t...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-018-1686-2
更新日期:2018-08-01 00:00:00
abstract::The objective of this study was to determine if aspirin users presenting with acute coronary syndromes are at higher risk for subsequent clinical events. In a trial evaluating combination antithrombotic therapy in resting angina or non-Q-wave myocardial infarction (MI), patients were prospectively dichotomized on admi...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1023/a:1008855220129
更新日期:1997-01-01 00:00:00
abstract::A main underlying pathology of coronary artery disease is the deposition of cholesterol in the arteries supplying blood to the heart that leads to stenosis and myocardial infarction. We tested if dyslipidemia is a risk factor for coronary artery disease in the Lebanese population, and studied the role of the total cho...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1007/s11239-014-1069-2
更新日期:2015-01-01 00:00:00
abstract::C-reactive protein (CRP) is an independent predictor of risk in ACS patients, and it has been previously shown that percutaneous coronary intervention (PCI) is associated with an early rise in CRP. To assess the long-term relationship between PCI and CRP, we compared CRP levels at baseline, 30 days, 4 months and 24 mo...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11239-010-0463-7
更新日期:2010-07-01 00:00:00
abstract::Hospital acquired venous thromboembolism (VTE) is a major source of morbidity and mortality, yet proven prevention measures are often underutilized. The lack of a validated VTE risk assessment model, difficulty integrating VTE risk assessment and prevention protocols into the routine process of care, and the lack of s...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-009-0405-4
更新日期:2010-02-01 00:00:00
abstract::The following manuscript presents two cases of ischemic stroke secondary to traumatic internal carotid artery thrombosis with concomitant middle cerebral artery thrombosis occurring very rarely in the medico-legal practice. Penetrating neck trauma due to an occupational accident and multiple head and neck trauma secon...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-014-1077-2
更新日期:2014-10-01 00:00:00
abstract::Deep vein thrombosis (DVT) in hemiplegic patients mainly affects hemiplegic limbs, DVT can also occur only in healthy limbs, and some hemiplegic patients have DVT in both limbs. Characteristics and risk factors of DVT in hemiplegic, healthy, and bilateral limbs are unknown. To describe the proportion, risk factors, ex...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-020-02254-w
更新日期:2020-08-27 00:00:00
abstract::There were limited studies comparing the anterior (AC) and posterior (PC) circulation acute ischemic strokes (AIS). Our study aimed to evaluate distinct features of AC and PC strokes regarding clinical, vascular risk, pathogenesis and outcome factors after endovascular procedures. This multicenter prospective study re...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-020-02054-2
更新日期:2020-05-01 00:00:00
abstract::We assessed the contribution of serum homocysteine levels, an independent risk factor for vascular disease, and of the methylenetetrahydrofolate reductase (MTHFR) C677T mutation to the variability of carotid intimal-medial thickness (IMT) in patients with non-insulin-dependent diabetes mellitus (NIDDM). Ninety-five pa...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 临床试验,杂志文章
doi:10.1023/a:1008962220476
更新日期:1999-10-01 00:00:00
abstract::The American College of Chest Physicians (ACCP) has established guidelines for the treatment of VTE, but the generalizability to all populations is unclear. In this review we analyzed the rate of reporting and enrollment of blacks and women in clinical trials cited in the ACCP guidelines for treatment of unprovoked VT...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,评审
doi:10.1007/s11239-016-1352-5
更新日期:2016-08-01 00:00:00
abstract::Recent evidence indicates that endothelial progenitor cells (EPCs) have an important role in the process of repair following vascular injury, and that platelets mediate their recruitment to sites of injury. Platelets and EPCs can interact and bind directly. However, there is limited information on the effect of platel...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-010-0514-0
更新日期:2010-11-01 00:00:00
abstract::Patients with inflammatory bowel disease (IBD) have a 1.5-3.5-fold higher risk of thromboembolism when compared to the non-IBD population and the risk is much more prominent at the time of a flare. Arterial thromboembolism (ischemic stroke, focal white matter ischemia, cardiac ischemia, peripheral vascular disease and...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,评审
doi:10.1007/s11239-014-1129-7
更新日期:2015-05-01 00:00:00
abstract::To investigate the relationship between circulating microRNA 223 (miR-223) levels and clopidogrel responsiveness in patients with coronary heart disease. A total of 62 consecutive patients with troponin-negative non-ST elevation acute coronary syndrome (NSTE-ACS) scheduled for elective percutaneous coronary interventi...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 临床试验,杂志文章
doi:10.1007/s11239-013-1022-9
更新日期:2014-07-01 00:00:00
abstract:INTRODUCTION:While the CURE trial demonstrated the benefits of clopidogrel in acute coronary syndromes, patients receiving glycoprotein IIb/IIIa antagonists were excluded. Given the frequent coadministration of these two medications, we sought to examine their interaction and their combined effect on platelet inhibitio...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-004-0170-3
更新日期:2004-08-01 00:00:00
abstract::Since the reports by Weismann and Tobin in 1958 and Roberts et al. in 1964 called attention to paradoxical thrombosis in patients treated with heparin, the thrombotic aspect of the heparin-induced thrombocytopenia syndrome (HIT) has been emphasized. Yet to this day, the mechanism of thrombosis associated with HIT (HIT...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,评审
doi:10.1023/a:1027372901367
更新日期:2000-11-01 00:00:00
abstract::Tranexamic acid (TXA) can reduce blood loss and transfusion rates in orthopaedic surgery. In this regard, a new viscoelastometric test (TPA-test, ClotPro), enables the monitoring of TXA effects. This prospective observational study evaluated and correlated TXA plasma concentrations (cTXA) following intravenous and ora...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-020-02272-8
更新日期:2020-09-12 00:00:00
abstract::Fibrinolysis is regulated by the thrombin/thrombin-activatable fibrinolysis inhibitor (TAFI) system. Thus, anticoagulants and inhibitors of TAFI are expected to accelerate fibrinolysis. The combined effects of an anticoagulant and a TAFIa inhibitor on fibrinolysis remain unknown. The aim of this study was to evaluate ...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-019-01929-3
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:The endothelial ADP receptor P2Y(1) is responsible for a large part of the reactive hyperemia following cardiac ischemia. Tissue plasminogen activator (t-PA) increases during reactive hyperemia. We postulated that the release of t-PA during reactive hyperemia could be mitigated through blocking the coronary ...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-007-0010-3
更新日期:2007-10-01 00:00:00
abstract::To analyze the efficacy and safety of activated prothrombin complex concentrates (aPCC) and four-factor prothrombin complex concentrates (4F-PCC) to prevent hematoma expansion in patients taking apixaban or rivaroxaban with intracranial hemorrhage (ICH). In this multicenter, retrospective study, sixty-seven ICH patien...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-020-02154-z
更新日期:2021-01-01 00:00:00
abstract::The adverse impact of the development of cardiogenic shock in the setting of acute myocardial infarction was first described by Killip and Kimball in 1967. While the in-hospital mortality rate in patients with myocardial infarction and no evidence of heart failure was only 6%, the mortality rate in those patients who ...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/BF01063156
更新日期:1995-01-01 00:00:00
abstract::A 64-year-old man first developed ligneous conjunctivitis at the age of 58 years after right pulmonary resection because of suspected cancer; otherwise, he had been healthy. Since then, he began to suffer from various forms of chronic pseudomembranous mucositis. Laboratory tests demonstrated that he had 7.8 % of plasm...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-016-1375-y
更新日期:2016-08-01 00:00:00
abstract::Thromboembolism afflicts millions of patients annually in the United States and is associated with a significant cost burden. Recent advances in oral anticoagulation have provided clinicians with more options for management of these diseases. Accordingly, regulatory, legislative, and policy-making organizations have i...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,评审
doi:10.1007/s11239-015-1198-2
更新日期:2015-04-01 00:00:00
abstract::Infarct artery stenting with adjunctive abciximab therapy is widely used treatment for patients with acute myocardial infarction (AMI). However, bleeding complications have been associated with a worse clinical outcome. Randomized trials in elective patients have shown that postprocedural protamine administration is s...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-010-0481-5
更新日期:2010-11-01 00:00:00
abstract::Several newer anticoagulants are under clinical development. Recently two of them, Dabigatran etexilate/Pradaxa. and Rivaroxaban/Xarelto obtained marketing authorization in Europe and Canada for the prevention of thromboembolic events following major orthopedic surgery such as total hip and knee replacement. The resul...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,评审
doi:10.1007/s11239-009-0392-5
更新日期:2010-01-01 00:00:00
abstract::The role of the A>G polymorphism at position 19911 in the prothrombin gene (factor [F] 2 at rs3136516) as a risk factor for venous thromboembolism [VTE] is still unclear. To evaluate the presence of the F2 polymorphism in VTE patients compared to healthy blood donors and to adjust the results for common inherited thro...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-020-02169-6
更新日期:2020-06-27 00:00:00