Catheter-based reperfusion of unprotected left main stenosis during an acute myocardial infarction (the ULTIMA experience)

Steven P. Marso, Gabriel Steg, Thijs Plokker, David Holmes, Seung Jung Park, Kunihiko Kosuga, Hideo Tamai, Carlos Macaya, Jeffery Moses, Harvey White, S. F.C. Verstraete, Stephen G. Ellis

Research output: Contribution to journalArticle

108 Citations (Scopus)

Abstract

The ULTIMA registry was a prospective, multicenter, international registry of 277 patients who underwent percutaneous coronary interventions of unprotected left main trunk stenosis. The 40 patients who underwent an emergency percutaneous left main intervention for acute myocardial infarction are the focus of this study. We compared the results of primary angioplasty with primary stenting, characterizing both the short-term (inhospital) and long-term (12-month) outcomes. Of the 40 patients, 23 underwent primary angioplasty, whereas 17 underwent primary stenting. The angiographic success rate was an 88% for the cohort. The in-hospital death or coronary artery bypass grafting rate was 65% for the entire group, 74% for the percutaneous transluminal coronary angioplasty group (PTCA), and 53% for the stent group [p = 0.2). The in-hospital death rate was 55% for the entire cohort, 70% for the PTCA group, and 35% for the stent group (p = 0.1). The 12-month rate of death or bypass surgery was 83% and 58% for the PTCA and stent groups, respectively (p = 0.047). The 12-month survival rate was 35% and 53% for the PTCA and stent groups, respectively (p = 0.18). Bypass surgery was required in 6 patients in the PTCA group and 2 patients in the stent group (p = 0.07). Patients undergoing percutaneous interventions for unprotected left main myocardial stenosis during an acute myocardial infarction are critically ill; an initial percutaneous revascularization approach appears feasible and may be the preferred revascularization strategy. Primary stenting was associated with improved clinical outcomes.

Original languageEnglish (US)
Pages (from-to)1513-1517
Number of pages5
JournalAmerican Journal of Cardiology
Volume83
Issue number11
DOIs
StatePublished - Jun 1 1999

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Coronary Balloon Angioplasty
Reperfusion
Pathologic Constriction
Catheters
Stents
Myocardial Infarction
Angioplasty
Registries
Mortality
Percutaneous Coronary Intervention
Critical Illness
Coronary Artery Bypass
Emergencies
Survival Rate

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Catheter-based reperfusion of unprotected left main stenosis during an acute myocardial infarction (the ULTIMA experience). / Marso, Steven P.; Steg, Gabriel; Plokker, Thijs; Holmes, David; Park, Seung Jung; Kosuga, Kunihiko; Tamai, Hideo; Macaya, Carlos; Moses, Jeffery; White, Harvey; Verstraete, S. F.C.; Ellis, Stephen G.

In: American Journal of Cardiology, Vol. 83, No. 11, 01.06.1999, p. 1513-1517.

Research output: Contribution to journalArticle

Marso, SP, Steg, G, Plokker, T, Holmes, D, Park, SJ, Kosuga, K, Tamai, H, Macaya, C, Moses, J, White, H, Verstraete, SFC & Ellis, SG 1999, 'Catheter-based reperfusion of unprotected left main stenosis during an acute myocardial infarction (the ULTIMA experience)', American Journal of Cardiology, vol. 83, no. 11, pp. 1513-1517. https://doi.org/10.1016/S0002-9149(99)00139-3
Marso, Steven P. ; Steg, Gabriel ; Plokker, Thijs ; Holmes, David ; Park, Seung Jung ; Kosuga, Kunihiko ; Tamai, Hideo ; Macaya, Carlos ; Moses, Jeffery ; White, Harvey ; Verstraete, S. F.C. ; Ellis, Stephen G. / Catheter-based reperfusion of unprotected left main stenosis during an acute myocardial infarction (the ULTIMA experience). In: American Journal of Cardiology. 1999 ; Vol. 83, No. 11. pp. 1513-1517.
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AU - Holmes, David

AU - Park, Seung Jung

AU - Kosuga, Kunihiko

AU - Tamai, Hideo

AU - Macaya, Carlos

AU - Moses, Jeffery

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AU - Verstraete, S. F.C.

AU - Ellis, Stephen G.

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