Skip to main content
Journal cover image

Comparison of primary coronary angioplasty versus thrombolysis in patients with ST-segment elevation acute myocardial infarction and grade II and grade III myocardial ischemia on the enrollment electrocardiogram.

Publication ,  Journal Article
Birnbaum, Y; Goodman, S; Barr, A; Gates, KB; Barbash, GI; Battler, A; Barbagelata, A; Clemmensen, P; Sgarbossa, EB; Granger, CB; Califf, RM ...
Published in: Am J Cardiol
October 15, 2001

We investigated the impact of primary angioplasty compared with thrombolysis in 894 patients with ST elevation acute myocardial infarction and electrocardiographic grades II and III ischemia on enrollment. Patients were divided into 2 groups based on the enrollment electrocardiogram-grade III: (1) absence of an S wave below the isoelectric baseline in leads that usually have a terminal S configuration (leads V(1) to V(3)), or (2) ST J-point amplitude > or =50% of the R-wave amplitude in all other leads. To be included in the grade III group, grade III criteria in > or =2 adjacent leads were required. Patients with ST elevation but without grade III criteria were classified as having grade II. In-hospital mortality was 3.2% and 6.8% in the grade II (n = 616) and grade III (n = 278) groups, respectively (p = 0.016). In the grade II group, in-hospital mortality was similar in the thrombolysis and angioplasty subgroups (3.2% and 3.3%, p = 0.941). In patients with grade III, in-hospital mortality was 6.4% and 7.3%, respectively (p = 0.762). The odds ratio for the grade III group for death with thrombolysis was 2.06 (95% confidence intervals [CI] 0.82 to 5.19; p = 0.125); the odds ratio for primary angioplasty was 2.30 (95% CI 0.93 to 5.66; p = 0.07). In the thrombolysis group, reinfarction occurred in 3.3% and 6.5% of the grade II and grade III subgroups (p = 0.137). In the angioplasty group, reinfarction occurred in 1.3% and 4.4%, respectively (p = 0.239). Grade III ischemia on admission was associated with higher in-hospital and 30-day mortality and a higher rate of reinfarction. There was no difference in mortality between primary angioplasty and thrombolysis in the grade II and grade III ischemia patients.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Am J Cardiol

DOI

ISSN

0002-9149

Publication Date

October 15, 2001

Volume

88

Issue

8

Start / End Page

842 / 847

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Tissue Plasminogen Activator
  • Thrombolytic Therapy
  • Retrospective Studies
  • Myocardial Ischemia
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
  • Hospital Mortality
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Birnbaum, Y., Goodman, S., Barr, A., Gates, K. B., Barbash, G. I., Battler, A., … Wagner, G. S. (2001). Comparison of primary coronary angioplasty versus thrombolysis in patients with ST-segment elevation acute myocardial infarction and grade II and grade III myocardial ischemia on the enrollment electrocardiogram. Am J Cardiol, 88(8), 842–847. https://doi.org/10.1016/s0002-9149(01)01889-6
Birnbaum, Y., S. Goodman, A. Barr, K. B. Gates, G. I. Barbash, A. Battler, A. Barbagelata, et al. “Comparison of primary coronary angioplasty versus thrombolysis in patients with ST-segment elevation acute myocardial infarction and grade II and grade III myocardial ischemia on the enrollment electrocardiogram.Am J Cardiol 88, no. 8 (October 15, 2001): 842–47. https://doi.org/10.1016/s0002-9149(01)01889-6.
Birnbaum Y, Goodman S, Barr A, Gates KB, Barbash GI, Battler A, Barbagelata A, Clemmensen P, Sgarbossa EB, Granger CB, Califf RM, Wagner GS. Comparison of primary coronary angioplasty versus thrombolysis in patients with ST-segment elevation acute myocardial infarction and grade II and grade III myocardial ischemia on the enrollment electrocardiogram. Am J Cardiol. 2001 Oct 15;88(8):842–847.
Journal cover image

Published In

Am J Cardiol

DOI

ISSN

0002-9149

Publication Date

October 15, 2001

Volume

88

Issue

8

Start / End Page

842 / 847

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Tissue Plasminogen Activator
  • Thrombolytic Therapy
  • Retrospective Studies
  • Myocardial Ischemia
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
  • Hospital Mortality