Value of first day angiography/angioplasty in evolving Non-ST segment elevation myocardial infarction: an open multicenter randomized trial. The VINO Study

Direct angioplasty is an effective treatment for ST-elevation myocardial infarction. The role of very early angioplasty in non-ST-elevation infarction is not known. Thus, a randomized study of first day angiography/angioplasty vs early conservative therapy of evolving myocardial infarction without p...

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Bibliographic Details
Published in:European heart journal 2002-02, Vol.23 (3), p.230-238
Main Authors: Spacek, R, Widimský, P, Straka, Z, Jiresová, E, Dvorák, J, Polásek, R, Karel, I, Jirmár, R, Lisa, L, Budesínský, T, Málek, F, Stanka, P
Format: Article
Language:English
Subjects:
Aged
Angioplasty, Balloon, Coronary
Coronary Angiography
Coronary Artery Bypass
Electrocardiography
Endpoint Determination
Exercise Test
Female
Follow-Up Studies
Humans
Length of Stay
Male
Middle Aged
Myocardial Infarction - diagnostic imaging
Myocardial Infarction - mortality
Myocardial Infarction - therapy
Survival Analysis
Treatment Outcome
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Summary:Direct angioplasty is an effective treatment for ST-elevation myocardial infarction. The role of very early angioplasty in non-ST-elevation infarction is not known. Thus, a randomized study of first day angiography/angioplasty vs early conservative therapy of evolving myocardial infarction without persistent ST-elevation was conducted. One hundred and thirty-one patients with confirmed acute myocardial infarction without ST-segment elevations were randomized within 24 h of last rest chest pain: 64 in the first day angiography/angioplasty group and 67 in the early conservative group (coronary angiography only after recurrent or stress induced myocardial ischaemia). All patients in the invasive group underwent coronary angiography on the day of admission (mean randomization-angiography time 6.2 h). First day angioplasty of the infarct related artery was performed in 47% of the patients and bypass surgery in 35%. In the conservative group, 55% underwent coronary angiography, 10% angioplasty and 30% bypass surgery within 6 months. The primary end-point (death/reinfarction) at 6 months occurred in 6.2% vs 22.3% (P
ISSN:0195-668X
1522-9645
DOI:10.1053/euhj.2001.2735