title: [Comparative efficacy of pharmacoinvasive strategy of myocardial reperfusion and primary angioplasty in patients with acute ST elevation myocardial infarction].
abstract: In order to assess comparative efficacy of pharmacoinvasive strategy of myocardial reperfusion and primary angioplasty in ST elevation acute myocardial infarction 289 patients were randomized at prehospital stage within first 6 hours of the disease into 2 groups: primary angioplasty (group 1), and prehospital thrombolysis with subsequent rescue or delayed angioplasty depending on efficacy of thrombolysis. We analyzed clinical and anamnestic characteristics of patients, efficacy of reperfusion measures, dimensions of myocardial necrosis, and clinical course of the disease. Pharmacoinvasive myocardial reperfusion with prehospital thrombolysis compared with primary coronary angioplasty decreased time of myocardial ischemia (224.65 +/- 71 vs. 278 +/- 184 min, p < 0.03), increased rate of achievement of TIMI grade 3 flow after percutaneous coronary intervention (80.5% vs. 71.4%, p = 0.002) and more effectively preserved left ventricular ejection fraction (60.0 +/- 14.9% vs. 54.9 +/- 12.3%, p < 0.01). Prehospital thrombolysis before coronary angioplasty compared with primary angioplasty was associated with lower rate of development of no-reflow syndrome (1.4% vs. 11.6%, p < 0.003).
authors.forename: V A
authors.initials: VA
authors.lastname: Markov
authors.forename: E V
authors.initials: EV
authors.lastname: Vyshlov
authors.forename: D S
authors.initials: DS
authors.lastname: Sevast'ianova
authors.forename: V Iu
authors.initials: VIu
authors.lastname: Filiushkina
authors.forename: S V
authors.initials: SV
authors.lastname: Dem'ianov
authors.forename: I V
authors.initials: IV
authors.lastname: Maksimov
authors.forename: S I
authors.initials: SI
authors.lastname: Antipov
authors.forename: A L
authors.initials: AL
authors.lastname: Krylov
authors.forename: V I
authors.initials: VI
authors.lastname: Varvarenko
authors.forename: S G
authors.initials: SG
authors.lastname: Gol'tsov
authors.forename: V V
authors.initials: VV
authors.lastname: Markov
authors.forename: A M
authors.initials: AM
authors.lastname: Danilenko
authors.forename: R S
authors.initials: RS
authors.lastname: Karpov
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D015425:Myocardial Reperfusion / Q000379:methods*; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D017410:Practice Guidelines as Topic; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D010959:Tissue Plasminogen Activator