Comparison of primary angioplasty with conservative therapy in patients with acute myocardial infarction and contraindications for thrombolytic therapy
Identifieur interne : 001821 ( Istex/Corpus ); précédent : 001820; suivant : 001822Comparison of primary angioplasty with conservative therapy in patients with acute myocardial infarction and contraindications for thrombolytic therapy
Auteurs : Ralf Zahn ; Stefan Schuster ; Rudolf Schiele ; Karlheinz Seidl ; Thomas Voigtl Nder ; Jürgen Meyer ; Karl E. Hauptmann ; Martin Gottwik ; Gunther Berg ; Thomas Kunz ; Ulf Gieseler ; Michael Jakob ; Jochen SengesSource :
- Catheterization and Cardiovascular Interventions [ 1522-1946 ] ; 1999-02.
English descriptors
Abstract
The benefit of primary angioplasty in patients with acute myocardial infarction (AMI) and contraindications for thrombolysis compared to a conservative regimen is still unclear. Out of 5,869 patients with AMI registered by the MITRA trial, 337 (5.7%) patients had at least one strong contraindication for thrombolytic therapy. Out of these 337 patients 46 (13.6%) were treated with primary angioplasty and 276 (86.4%) were treated conservatively. Patients treated conservatively were older (70 years vs. 60 years; P = 0.001), had a higher rate of a history with chronic heart failure (14.8% vs. 4.4%; P = 0.053), a higher heart rate at admission (86 beats/min vs. 74 beats/min; P = 0.001), and a higher prevalence of diabetes mellitus (27.1% vs. 12.8%; P = 0.056). Patients treated with primary angioplasty received more often aspirin (91.3% vs. 74.6%; P = 0.012), β‐blockers (60.9% vs. 46.1%; P = 0.062), angiotensin converting enzyme (ACE) inhibitors (71.7% vs. 44%; P = 0.001), and the so‐called optimal adjunctive medication (54.4% vs. 32.3%; P = 0.004). Hospital mortality was significantly lower in patients who received primary angioplasty (univariate: 2.2% vs. 24.7%; P = 0.001; multivariate: OR = 0.46; P = 0.0230). In patients with AMI and contraindications for thrombolytic therapy, primary angioplasty was associated with a significantly lower mortality compared to conservative treatment. Therefore, hospitals without the facilities to perform primary angioplasty should try to refer such patients to centers with the facilities for such a service, if this is possible in an acceptable time.Cathet. Cardiovasc. Intervent. 46:127–133, 1999. © 1999 Wiley‐Liss, Inc.
Url:
DOI: 10.1002/(SICI)1522-726X(199902)46:2<127::AID-CCD2>3.0.CO;2-G
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ISTEX:E70582777FF26D6B2D3A057AF1048B70BB094687Le document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Comparison of primary angioplasty with conservative therapy in patients with acute myocardial infarction and contraindications for thrombolytic therapy</title><author><name sortKey="Zahn, Ralf" sort="Zahn, Ralf" uniqKey="Zahn R" first="Ralf" last="Zahn">Ralf Zahn</name><affiliation><mods:affiliation>Department of Cardiology, Herzzentrum Ludwigshafen, Ludwigshafen, Germany</mods:affiliation></affiliation><affiliation><mods:affiliation>Herzzentrum Ludwigshafen, Department of Cardiology, Bremserstrasse 79, D‐67063 Ludwigshafen,Germany.</mods:affiliation></affiliation></author><author><name sortKey="Schuster, Stefan" sort="Schuster, Stefan" uniqKey="Schuster S" first="Stefan" last="Schuster">Stefan Schuster</name><affiliation><mods:affiliation>Department of Cardiology, St. Antonius Hospital, Kleve, Germany</mods:affiliation></affiliation></author><author><name sortKey="Schiele, Rudolf" sort="Schiele, Rudolf" uniqKey="Schiele R" first="Rudolf" last="Schiele">Rudolf Schiele</name><affiliation><mods:affiliation>Department of Cardiology, Herzzentrum Ludwigshafen, Ludwigshafen, Germany</mods:affiliation></affiliation></author><author><name sortKey="Seidl, Karlheinz" sort="Seidl, Karlheinz" uniqKey="Seidl K" first="Karlheinz" last="Seidl">Karlheinz Seidl</name><affiliation><mods:affiliation>Department of Cardiology, Herzzentrum Ludwigshafen, Ludwigshafen, Germany</mods:affiliation></affiliation></author><author><name sortKey="Voigtl Nder, Thomas" sort="Voigtl Nder, Thomas" uniqKey="Voigtl Nder T" first="Thomas" last="Voigtl Nder">Thomas Voigtl Nder</name><affiliation><mods:affiliation>Department of Cardiology, Johannes Gutenberg Universität, Mainz, Germany</mods:affiliation></affiliation></author><author><name sortKey="Meyer, Jurgen" sort="Meyer, Jurgen" uniqKey="Meyer J" first="Jürgen" last="Meyer">Jürgen Meyer</name><affiliation><mods:affiliation>Department of Cardiology, Johannes Gutenberg Universität, Mainz, Germany</mods:affiliation></affiliation></author><author><name sortKey="Hauptmann, Karl E" sort="Hauptmann, Karl E" uniqKey="Hauptmann K" first="Karl E." last="Hauptmann">Karl E. Hauptmann</name><affiliation><mods:affiliation>Department of Cardiology, Krankenhaus der Barmherzigen Brüder, Trier, Germany</mods:affiliation></affiliation></author><author><name sortKey="Gottwik, Martin" sort="Gottwik, Martin" uniqKey="Gottwik M" first="Martin" last="Gottwik">Martin Gottwik</name><affiliation><mods:affiliation>Department of Cardiology, Städtisches Klinikum, Nürnberg, Germany</mods:affiliation></affiliation></author><author><name sortKey="Berg, Gunther" sort="Berg, Gunther" uniqKey="Berg G" first="Gunther" last="Berg">Gunther Berg</name><affiliation><mods:affiliation>Department of Cardiology, Universitätskliniken, Homburg/Saar, Germany</mods:affiliation></affiliation></author><author><name sortKey="Kunz, Thomas" sort="Kunz, Thomas" uniqKey="Kunz T" first="Thomas" last="Kunz">Thomas Kunz</name><affiliation><mods:affiliation>Department of Cardiology, Winterbergkliniken, Saarbrücken, Germany</mods:affiliation></affiliation></author><author><name sortKey="Gieseler, Ulf" sort="Gieseler, Ulf" uniqKey="Gieseler U" first="Ulf" last="Gieseler">Ulf Gieseler</name><affiliation><mods:affiliation>Department of Cardiology, Diakonissenkrankenhaus, Speyer, Germany</mods:affiliation></affiliation></author><author><name sortKey="Jakob, Michael" sort="Jakob, Michael" uniqKey="Jakob M" first="Michael" last="Jakob">Michael Jakob</name><affiliation><mods:affiliation>Department of Cardiology, Knappschaftskrankenhaus, Sulzbach, Germany</mods:affiliation></affiliation></author><author><name sortKey="Senges, Jochen" sort="Senges, Jochen" uniqKey="Senges J" first="Jochen" last="Senges">Jochen Senges</name><affiliation><mods:affiliation>Department of Cardiology, Herzzentrum Ludwigshafen, Ludwigshafen, Germany</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:E70582777FF26D6B2D3A057AF1048B70BB094687</idno><date when="1999" year="1999">1999</date><idno type="doi">10.1002/(SICI)1522-726X(199902)46:2<127::AID-CCD2>3.0.CO;2-G</idno><idno type="url">https://api.istex.fr/document/E70582777FF26D6B2D3A057AF1048B70BB094687/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">001821</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">001821</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Comparison of primary angioplasty with conservative therapy in patients with acute myocardial infarction and contraindications for thrombolytic therapy</title><author><name sortKey="Zahn, Ralf" sort="Zahn, Ralf" uniqKey="Zahn R" first="Ralf" last="Zahn">Ralf Zahn</name><affiliation><mods:affiliation>Department of Cardiology, Herzzentrum Ludwigshafen, Ludwigshafen, Germany</mods:affiliation></affiliation><affiliation><mods:affiliation>Herzzentrum Ludwigshafen, Department of Cardiology, Bremserstrasse 79, D‐67063 Ludwigshafen,Germany.</mods:affiliation></affiliation></author><author><name sortKey="Schuster, Stefan" sort="Schuster, Stefan" uniqKey="Schuster S" first="Stefan" last="Schuster">Stefan Schuster</name><affiliation><mods:affiliation>Department of Cardiology, St. Antonius Hospital, Kleve, Germany</mods:affiliation></affiliation></author><author><name sortKey="Schiele, Rudolf" sort="Schiele, Rudolf" uniqKey="Schiele R" first="Rudolf" last="Schiele">Rudolf Schiele</name><affiliation><mods:affiliation>Department of Cardiology, Herzzentrum Ludwigshafen, Ludwigshafen, Germany</mods:affiliation></affiliation></author><author><name sortKey="Seidl, Karlheinz" sort="Seidl, Karlheinz" uniqKey="Seidl K" first="Karlheinz" last="Seidl">Karlheinz Seidl</name><affiliation><mods:affiliation>Department of Cardiology, Herzzentrum Ludwigshafen, Ludwigshafen, Germany</mods:affiliation></affiliation></author><author><name sortKey="Voigtl Nder, Thomas" sort="Voigtl Nder, Thomas" uniqKey="Voigtl Nder T" first="Thomas" last="Voigtl Nder">Thomas Voigtl Nder</name><affiliation><mods:affiliation>Department of Cardiology, Johannes Gutenberg Universität, Mainz, Germany</mods:affiliation></affiliation></author><author><name sortKey="Meyer, Jurgen" sort="Meyer, Jurgen" uniqKey="Meyer J" first="Jürgen" last="Meyer">Jürgen Meyer</name><affiliation><mods:affiliation>Department of Cardiology, Johannes Gutenberg Universität, Mainz, Germany</mods:affiliation></affiliation></author><author><name sortKey="Hauptmann, Karl E" sort="Hauptmann, Karl E" uniqKey="Hauptmann K" first="Karl E." last="Hauptmann">Karl E. Hauptmann</name><affiliation><mods:affiliation>Department of Cardiology, Krankenhaus der Barmherzigen Brüder, Trier, Germany</mods:affiliation></affiliation></author><author><name sortKey="Gottwik, Martin" sort="Gottwik, Martin" uniqKey="Gottwik M" first="Martin" last="Gottwik">Martin Gottwik</name><affiliation><mods:affiliation>Department of Cardiology, Städtisches Klinikum, Nürnberg, Germany</mods:affiliation></affiliation></author><author><name sortKey="Berg, Gunther" sort="Berg, Gunther" uniqKey="Berg G" first="Gunther" last="Berg">Gunther Berg</name><affiliation><mods:affiliation>Department of Cardiology, Universitätskliniken, Homburg/Saar, Germany</mods:affiliation></affiliation></author><author><name sortKey="Kunz, Thomas" sort="Kunz, Thomas" uniqKey="Kunz T" first="Thomas" last="Kunz">Thomas Kunz</name><affiliation><mods:affiliation>Department of Cardiology, Winterbergkliniken, Saarbrücken, Germany</mods:affiliation></affiliation></author><author><name sortKey="Gieseler, Ulf" sort="Gieseler, Ulf" uniqKey="Gieseler U" first="Ulf" last="Gieseler">Ulf Gieseler</name><affiliation><mods:affiliation>Department of Cardiology, Diakonissenkrankenhaus, Speyer, Germany</mods:affiliation></affiliation></author><author><name sortKey="Jakob, Michael" sort="Jakob, Michael" uniqKey="Jakob M" first="Michael" last="Jakob">Michael Jakob</name><affiliation><mods:affiliation>Department of Cardiology, Knappschaftskrankenhaus, Sulzbach, Germany</mods:affiliation></affiliation></author><author><name sortKey="Senges, Jochen" sort="Senges, Jochen" uniqKey="Senges J" first="Jochen" last="Senges">Jochen Senges</name><affiliation><mods:affiliation>Department of Cardiology, Herzzentrum Ludwigshafen, Ludwigshafen, Germany</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Catheterization and Cardiovascular Interventions</title><title level="j" type="abbrev">Cathet. Cardiovasc. Intervent.</title><idno type="ISSN">1522-1946</idno><idno type="eISSN">1522-726X</idno><imprint><publisher>John Wiley & Sons, Inc.</publisher><pubPlace>New York</pubPlace><date type="published" when="1999-02">1999-02</date><biblScope unit="volume">46</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="127">127</biblScope><biblScope unit="page" to="133">133</biblScope></imprint><idno type="ISSN">1522-1946</idno></series><idno type="istex">E70582777FF26D6B2D3A057AF1048B70BB094687</idno><idno type="DOI">10.1002/(SICI)1522-726X(199902)46:2<127::AID-CCD2>3.0.CO;2-G</idno><idno type="ArticleID">CCD2</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1522-1946</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>contraindication</term><term>myocardial infarction</term><term>primary angioplasty</term><term>thrombolysis</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The benefit of primary angioplasty in patients with acute myocardial infarction (AMI) and contraindications for thrombolysis compared to a conservative regimen is still unclear. Out of 5,869 patients with AMI registered by the MITRA trial, 337 (5.7%) patients had at least one strong contraindication for thrombolytic therapy. Out of these 337 patients 46 (13.6%) were treated with primary angioplasty and 276 (86.4%) were treated conservatively. Patients treated conservatively were older (70 years vs. 60 years; P = 0.001), had a higher rate of a history with chronic heart failure (14.8% vs. 4.4%; P = 0.053), a higher heart rate at admission (86 beats/min vs. 74 beats/min; P = 0.001), and a higher prevalence of diabetes mellitus (27.1% vs. 12.8%; P = 0.056). Patients treated with primary angioplasty received more often aspirin (91.3% vs. 74.6%; P = 0.012), β‐blockers (60.9% vs. 46.1%; P = 0.062), angiotensin converting enzyme (ACE) inhibitors (71.7% vs. 44%; P = 0.001), and the so‐called optimal adjunctive medication (54.4% vs. 32.3%; P = 0.004). Hospital mortality was significantly lower in patients who received primary angioplasty (univariate: 2.2% vs. 24.7%; P = 0.001; multivariate: OR = 0.46; P = 0.0230). In patients with AMI and contraindications for thrombolytic therapy, primary angioplasty was associated with a significantly lower mortality compared to conservative treatment. Therefore, hospitals without the facilities to perform primary angioplasty should try to refer such patients to centers with the facilities for such a service, if this is possible in an acceptable time.Cathet. Cardiovasc. Intervent. 46:127–133, 1999. © 1999 Wiley‐Liss, Inc.</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Ralf Zahn MD</name><affiliations><json:string>Department of Cardiology, Herzzentrum Ludwigshafen, Ludwigshafen, Germany</json:string><json:string>Herzzentrum Ludwigshafen, Department of Cardiology, Bremserstrasse 79, D‐67063 Ludwigshafen,Germany.</json:string></affiliations></json:item><json:item><name>Stefan Schuster MD</name><affiliations><json:string>Department of Cardiology, St. Antonius Hospital, Kleve, Germany</json:string></affiliations></json:item><json:item><name>Rudolf Schiele MD</name><affiliations><json:string>Department of Cardiology, Herzzentrum Ludwigshafen, Ludwigshafen, Germany</json:string></affiliations></json:item><json:item><name>Karlheinz Seidl MD</name><affiliations><json:string>Department of Cardiology, Herzzentrum Ludwigshafen, Ludwigshafen, Germany</json:string></affiliations></json:item><json:item><name>Thomas Voigtländer MD</name><affiliations><json:string>Department of Cardiology, Johannes Gutenberg Universität, Mainz, Germany</json:string></affiliations></json:item><json:item><name>Jürgen Meyer MD</name><affiliations><json:string>Department of Cardiology, Johannes Gutenberg Universität, Mainz, Germany</json:string></affiliations></json:item><json:item><name>Karl E. Hauptmann MD</name><affiliations><json:string>Department of Cardiology, Krankenhaus der Barmherzigen Brüder, Trier, Germany</json:string></affiliations></json:item><json:item><name>Martin Gottwik MD</name><affiliations><json:string>Department of Cardiology, Städtisches Klinikum, Nürnberg, Germany</json:string></affiliations></json:item><json:item><name>Gunther Berg MD</name><affiliations><json:string>Department of Cardiology, Universitätskliniken, Homburg/Saar, Germany</json:string></affiliations></json:item><json:item><name>Thomas Kunz MD</name><affiliations><json:string>Department of Cardiology, Winterbergkliniken, Saarbrücken, Germany</json:string></affiliations></json:item><json:item><name>Ulf Gieseler MD</name><affiliations><json:string>Department of Cardiology, Diakonissenkrankenhaus, Speyer, Germany</json:string></affiliations></json:item><json:item><name>Michael Jakob MD</name><affiliations><json:string>Department of Cardiology, Knappschaftskrankenhaus, Sulzbach, Germany</json:string></affiliations></json:item><json:item><name>Jochen Senges MD</name><affiliations><json:string>Department of Cardiology, Herzzentrum Ludwigshafen, Ludwigshafen, Germany</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>myocardial infarction</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>primary angioplasty</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>thrombolysis</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>contraindication</value></json:item></subject><articleId><json:string>CCD2</json:string></articleId><language><json:string>eng</json:string></language><originalGenre><json:string>article</json:string></originalGenre><abstract>The benefit of primary angioplasty in patients with acute myocardial infarction (AMI) and contraindications for thrombolysis compared to a conservative regimen is still unclear. Out of 5,869 patients with AMI registered by the MITRA trial, 337 (5.7%) patients had at least one strong contraindication for thrombolytic therapy. Out of these 337 patients 46 (13.6%) were treated with primary angioplasty and 276 (86.4%) were treated conservatively. Patients treated conservatively were older (70 years vs. 60 years; P = 0.001), had a higher rate of a history with chronic heart failure (14.8% vs. 4.4%; P = 0.053), a higher heart rate at admission (86 beats/min vs. 74 beats/min; P = 0.001), and a higher prevalence of diabetes mellitus (27.1% vs. 12.8%; P = 0.056). Patients treated with primary angioplasty received more often aspirin (91.3% vs. 74.6%; P = 0.012), β‐blockers (60.9% vs. 46.1%; P = 0.062), angiotensin converting enzyme (ACE) inhibitors (71.7% vs. 44%; P = 0.001), and the so‐called optimal adjunctive medication (54.4% vs. 32.3%; P = 0.004). Hospital mortality was significantly lower in patients who received primary angioplasty (univariate: 2.2% vs. 24.7%; P = 0.001; multivariate: OR = 0.46; P = 0.0230). In patients with AMI and contraindications for thrombolytic therapy, primary angioplasty was associated with a significantly lower mortality compared to conservative treatment. Therefore, hospitals without the facilities to perform primary angioplasty should try to refer such patients to centers with the facilities for such a service, if this is possible in an acceptable time.Cathet. Cardiovasc. Intervent. 46:127–133, 1999. © 1999 Wiley‐Liss, Inc.</abstract><qualityIndicators><score>7.522</score><pdfVersion>1.2</pdfVersion><pdfPageSize>612 x 792 pts (letter)</pdfPageSize><refBibsNative>true</refBibsNative><abstractCharCount>1676</abstractCharCount><pdfWordCount>4522</pdfWordCount><pdfCharCount>31830</pdfCharCount><pdfPageCount>7</pdfPageCount><abstractWordCount>254</abstractWordCount></qualityIndicators><title>Comparison of primary angioplasty with conservative therapy in patients with acute myocardial infarction and contraindications for thrombolytic therapy</title><refBibs><json:item><author><json:item><name>TJ Ryan</name></json:item><json:item><name>JL Anderson</name></json:item><json:item><name>EM Antman</name></json:item><json:item><name>BA Braniff</name></json:item><json:item><name>NH Brooks</name></json:item><json:item><name>RM Califf</name></json:item><json:item><name>LD Hillis</name></json:item><json:item><name>LF Hiratzka</name></json:item><json:item><name>E 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Study</value></json:item></subject><genre><json:string>journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1522-726X</json:string></eissn><title>Catheterization and Cardiovascular Interventions</title><doi><json:string>10.1002/(ISSN)1522-726X</json:string></doi></host><publicationDate>1999</publicationDate><copyrightDate>1999</copyrightDate><doi><json:string>10.1002/(SICI)1522-726X(199902)46:2>127::AID-CCD2>3.0.CO;2-G</json:string></doi><id>E70582777FF26D6B2D3A057AF1048B70BB094687</id><score>0.1878414</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/document/E70582777FF26D6B2D3A057AF1048B70BB094687/fulltext/pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/document/E70582777FF26D6B2D3A057AF1048B70BB094687/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/E70582777FF26D6B2D3A057AF1048B70BB094687/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Comparison of primary angioplasty with conservative therapy in patients with acute myocardial infarction and contraindications for thrombolytic therapy</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>John Wiley & Sons, Inc.</publisher><pubPlace>New York</pubPlace><availability><p>Copyright © 1999 Wiley‐Liss, Inc.</p></availability><date>1999</date></publicationStmt><notesStmt><note>Zeneca</note><note>Bristol Myers‐Squibb</note><note>Ministerium für Gesundheit</note><note>Arbeit</note><note>Soziales des Landes Rheinland‐Pfalz</note><note>Landesversicherungsanstalt Rheinland‐Pfalz</note><note>Barmer und Betriebskrankenkassen Rheinland‐Pfalz</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Comparison of primary angioplasty with conservative therapy in patients with acute myocardial infarction and contraindications for thrombolytic therapy</title><author xml:id="author-1"><persName><forename type="first">Ralf</forename><surname>Zahn</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Cardiology, Herzzentrum Ludwigshafen, Ludwigshafen, Germany</affiliation><affiliation>Herzzentrum Ludwigshafen, Department of Cardiology, Bremserstrasse 79, D‐67063 Ludwigshafen,Germany.</affiliation></author><author xml:id="author-2"><persName><forename type="first">Stefan</forename><surname>Schuster</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Cardiology, St. Antonius Hospital, Kleve, Germany</affiliation></author><author xml:id="author-3"><persName><forename type="first">Rudolf</forename><surname>Schiele</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Cardiology, Herzzentrum Ludwigshafen, Ludwigshafen, Germany</affiliation></author><author xml:id="author-4"><persName><forename type="first">Karlheinz</forename><surname>Seidl</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Cardiology, Herzzentrum Ludwigshafen, Ludwigshafen, Germany</affiliation></author><author xml:id="author-5"><persName><forename type="first">Thomas</forename><surname>Voigtländer</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Cardiology, Johannes Gutenberg Universität, Mainz, Germany</affiliation></author><author xml:id="author-6"><persName><forename type="first">Jürgen</forename><surname>Meyer</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Cardiology, Johannes Gutenberg Universität, Mainz, Germany</affiliation></author><author xml:id="author-7"><persName><forename type="first">Karl E.</forename><surname>Hauptmann</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Cardiology, Krankenhaus der Barmherzigen Brüder, Trier, Germany</affiliation></author><author xml:id="author-8"><persName><forename type="first">Martin</forename><surname>Gottwik</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Cardiology, Städtisches Klinikum, Nürnberg, Germany</affiliation></author><author xml:id="author-9"><persName><forename type="first">Gunther</forename><surname>Berg</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Cardiology, Universitätskliniken, Homburg/Saar, Germany</affiliation></author><author xml:id="author-10"><persName><forename type="first">Thomas</forename><surname>Kunz</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Cardiology, Winterbergkliniken, Saarbrücken, Germany</affiliation></author><author xml:id="author-11"><persName><forename type="first">Ulf</forename><surname>Gieseler</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Cardiology, Diakonissenkrankenhaus, Speyer, Germany</affiliation></author><author xml:id="author-12"><persName><forename type="first">Michael</forename><surname>Jakob</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Cardiology, Knappschaftskrankenhaus, Sulzbach, Germany</affiliation></author><author xml:id="author-13"><persName><forename type="first">Jochen</forename><surname>Senges</surname></persName><roleName type="degree">MD</roleName><note type="biography">for the Maximal Individual Therapy in Acute Myocardial Infarction (MITRA) Study Group</note><affiliation>for the Maximal Individual Therapy in Acute Myocardial Infarction (MITRA) Study Group</affiliation><affiliation>Department of Cardiology, Herzzentrum Ludwigshafen, Ludwigshafen, Germany</affiliation></author></analytic><monogr><title level="j">Catheterization and Cardiovascular Interventions</title><title level="j" type="abbrev">Cathet. Cardiovasc. Intervent.</title><idno type="pISSN">1522-1946</idno><idno type="eISSN">1522-726X</idno><idno type="DOI">10.1002/(ISSN)1522-726X</idno><imprint><publisher>John Wiley & Sons, Inc.</publisher><pubPlace>New York</pubPlace><date type="published" when="1999-02"></date><biblScope unit="volume">46</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="127">127</biblScope><biblScope unit="page" to="133">133</biblScope></imprint></monogr><idno type="istex">E70582777FF26D6B2D3A057AF1048B70BB094687</idno><idno type="DOI">10.1002/(SICI)1522-726X(199902)46:2<127::AID-CCD2>3.0.CO;2-G</idno><idno type="ArticleID">CCD2</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>1999</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>The benefit of primary angioplasty in patients with acute myocardial infarction (AMI) and contraindications for thrombolysis compared to a conservative regimen is still unclear. Out of 5,869 patients with AMI registered by the MITRA trial, 337 (5.7%) patients had at least one strong contraindication for thrombolytic therapy. Out of these 337 patients 46 (13.6%) were treated with primary angioplasty and 276 (86.4%) were treated conservatively. Patients treated conservatively were older (70 years vs. 60 years; P = 0.001), had a higher rate of a history with chronic heart failure (14.8% vs. 4.4%; P = 0.053), a higher heart rate at admission (86 beats/min vs. 74 beats/min; P = 0.001), and a higher prevalence of diabetes mellitus (27.1% vs. 12.8%; P = 0.056). Patients treated with primary angioplasty received more often aspirin (91.3% vs. 74.6%; P = 0.012), β‐blockers (60.9% vs. 46.1%; P = 0.062), angiotensin converting enzyme (ACE) inhibitors (71.7% vs. 44%; P = 0.001), and the so‐called optimal adjunctive medication (54.4% vs. 32.3%; P = 0.004). Hospital mortality was significantly lower in patients who received primary angioplasty (univariate: 2.2% vs. 24.7%; P = 0.001; multivariate: OR = 0.46; P = 0.0230). In patients with AMI and contraindications for thrombolytic therapy, primary angioplasty was associated with a significantly lower mortality compared to conservative treatment. Therefore, hospitals without the facilities to perform primary angioplasty should try to refer such patients to centers with the facilities for such a service, if this is possible in an acceptable time.Cathet. Cardiovasc. Intervent. 46:127–133, 1999. © 1999 Wiley‐Liss, Inc.</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>keywords</head><item><term>myocardial infarction</term></item><item><term>primary angioplasty</term></item><item><term>thrombolysis</term></item><item><term>contraindication</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>article-category</head><item><term>Original Study</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="1998-05-11">Received</change><change when="1998-09-02">Registration</change><change when="1999-02">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/E70582777FF26D6B2D3A057AF1048B70BB094687/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>John Wiley & Sons, Inc.</publisherName><publisherLoc>New York</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1522-726X</doi><issn type="print">1522-1946</issn><issn type="electronic">1522-726X</issn><idGroup><id type="product" value="CCD"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS">Catheterization and Cardiovascular Interventions</title><title type="short">Cathet. 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value="CCD2"></id></idGroup><countGroup><count type="pageTotal" number="7"></count></countGroup><titleGroup><title type="articleCategory">Original Study</title><title type="tocHeading1">ORIGINAL STUDIES</title></titleGroup><copyright ownership="publisher">Copyright © 1999 Wiley‐Liss, Inc.</copyright><eventGroup><event type="manuscriptReceived" date="1998-05-11"></event><event type="manuscriptAccepted" date="1998-09-02"></event><event type="firstOnline" date="1999-02-04"></event><event type="publishedOnlineFinalForm" date="1999-02-04"></event><event type="xmlConverted" agent="Converter:JWSART34_TO_WML3G version:2.3.1 mode:FullText source:HeaderRef result:HeaderRef" date="2010-02-23"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-01-09"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-15"></event></eventGroup><numberingGroup><numbering type="pageFirst">127</numbering><numbering type="pageLast">133</numbering></numberingGroup><correspondenceTo>Herzzentrum Ludwigshafen, Department of Cardiology, Bremserstrasse 79, D‐67063 Ludwigshafen,Germany.</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:CCD.CCD2.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="0"></count><count type="tableTotal" number="3"></count><count type="referenceTotal" number="36"></count><count type="wordTotal" number="5625"></count></countGroup><titleGroup><title type="main" xml:lang="en">Comparison of primary angioplasty with conservative therapy in patients with acute myocardial infarction and contraindications for thrombolytic therapy</title><title type="short" xml:lang="en">Primary Angioplasty</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1" corresponding="yes"><personName><givenNames>Ralf</givenNames><familyName>Zahn</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Stefan</givenNames><familyName>Schuster</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Rudolf</givenNames><familyName>Schiele</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Karlheinz</givenNames><familyName>Seidl</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af3"><personName><givenNames>Thomas</givenNames><familyName>Voigtländer</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af3"><personName><givenNames>Jürgen</givenNames><familyName>Meyer</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au7" creatorRole="author" affiliationRef="#af4"><personName><givenNames>Karl E.</givenNames><familyName>Hauptmann</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au8" creatorRole="author" affiliationRef="#af5"><personName><givenNames>Martin</givenNames><familyName>Gottwik</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au9" creatorRole="author" affiliationRef="#af6"><personName><givenNames>Gunther</givenNames><familyName>Berg</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au10" creatorRole="author" affiliationRef="#af7"><personName><givenNames>Thomas</givenNames><familyName>Kunz</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au11" creatorRole="author" affiliationRef="#af8"><personName><givenNames>Ulf</givenNames><familyName>Gieseler</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au12" creatorRole="author" affiliationRef="#af9"><personName><givenNames>Michael</givenNames><familyName>Jakob</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au13" creatorRole="author" affiliationRef="#af1" noteRef="#fn1"><personName><givenNames>Jochen</givenNames><familyName>Senges</familyName><degrees>MD</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="DE" type="organization"><unparsedAffiliation>Department of Cardiology, Herzzentrum Ludwigshafen, Ludwigshafen, Germany</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="DE" type="organization"><unparsedAffiliation>Department of Cardiology, St. Antonius Hospital, Kleve, Germany</unparsedAffiliation></affiliation><affiliation xml:id="af3" countryCode="DE" type="organization"><unparsedAffiliation>Department of Cardiology, Johannes Gutenberg Universität, Mainz, Germany</unparsedAffiliation></affiliation><affiliation xml:id="af4" countryCode="DE" type="organization"><unparsedAffiliation>Department of Cardiology, Krankenhaus der Barmherzigen Brüder, Trier, Germany</unparsedAffiliation></affiliation><affiliation xml:id="af5" countryCode="DE" type="organization"><unparsedAffiliation>Department of Cardiology, Städtisches Klinikum, Nürnberg, Germany</unparsedAffiliation></affiliation><affiliation xml:id="af6" countryCode="DE" type="organization"><unparsedAffiliation>Department of Cardiology, Universitätskliniken, Homburg/Saar, Germany</unparsedAffiliation></affiliation><affiliation xml:id="af7" countryCode="DE" type="organization"><unparsedAffiliation>Department of Cardiology, Winterbergkliniken, Saarbrücken, Germany</unparsedAffiliation></affiliation><affiliation xml:id="af8" countryCode="DE" type="organization"><unparsedAffiliation>Department of Cardiology, Diakonissenkrankenhaus, Speyer, Germany</unparsedAffiliation></affiliation><affiliation xml:id="af9" countryCode="DE" type="organization"><unparsedAffiliation>Department of Cardiology, Knappschaftskrankenhaus, Sulzbach, Germany</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">myocardial infarction</keyword><keyword xml:id="kwd2">primary angioplasty</keyword><keyword xml:id="kwd3">thrombolysis</keyword><keyword xml:id="kwd4">contraindication</keyword></keywordGroup><fundingInfo><fundingAgency>Zeneca</fundingAgency></fundingInfo><fundingInfo><fundingAgency>Bristol Myers‐Squibb</fundingAgency></fundingInfo><fundingInfo><fundingAgency>Ministerium für Gesundheit</fundingAgency></fundingInfo><fundingInfo><fundingAgency>Arbeit</fundingAgency></fundingInfo><fundingInfo><fundingAgency>Soziales des Landes Rheinland‐Pfalz</fundingAgency></fundingInfo><fundingInfo><fundingAgency>Landesversicherungsanstalt Rheinland‐Pfalz</fundingAgency></fundingInfo><fundingInfo><fundingAgency>Barmer und Betriebskrankenkassen Rheinland‐Pfalz</fundingAgency></fundingInfo><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>The benefit of primary angioplasty in patients with acute myocardial infarction (AMI) and contraindications for thrombolysis compared to a conservative regimen is still unclear. Out of 5,869 patients with AMI registered by the MITRA trial, 337 (5.7%) patients had at least one strong contraindication for thrombolytic therapy. Out of these 337 patients 46 (13.6%) were treated with primary angioplasty and 276 (86.4%) were treated conservatively. Patients treated conservatively were older (70 years vs. 60 years;<i> P</i> = 0.001), had a higher rate of a history with chronic heart failure (14.8% vs. 4.4%; <i>P</i> = 0.053), a higher heart rate at admission (86 beats/min vs. 74 beats/min; <i>P</i> = 0.001), and a higher prevalence of diabetes mellitus (27.1% vs. 12.8%; <i>P</i> = 0.056). Patients treated with primary angioplasty received more often aspirin (91.3% vs. 74.6%;<i> P</i> = 0.012), β‐blockers (60.9% vs. 46.1%; <i>P</i> = 0.062), angiotensin converting enzyme (ACE) inhibitors (71.7% vs. 44%; <i>P</i> = 0.001), and the so‐called optimal adjunctive medication (54.4% vs. 32.3%; <i>P</i> = 0.004). Hospital mortality was significantly lower in patients who received primary angioplasty (univariate: 2.2% vs. 24.7%; <i>P</i> = 0.001; multivariate: OR = 0.46;<i> P</i> = 0.0230). In patients with AMI and contraindications for thrombolytic therapy, primary angioplasty was associated with a significantly lower mortality compared to conservative treatment. Therefore, hospitals without the facilities to perform primary angioplasty should try to refer such patients to centers with the facilities for such a service, if this is possible in an acceptable time.Cathet. Cardiovasc. Intervent. 46:127–133, 1999. © 1999 Wiley‐Liss, Inc.</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn1"><p>for the Maximal Individual Therapy in Acute Myocardial Infarction (MITRA) Study Group</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Comparison of primary angioplasty with conservative therapy in patients with acute myocardial infarction and contraindications for thrombolytic therapy</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Primary Angioplasty</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Comparison of primary angioplasty with conservative therapy in patients with acute myocardial infarction and contraindications for thrombolytic therapy</title></titleInfo><name type="personal"><namePart type="given">Ralf</namePart><namePart type="family">Zahn</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Cardiology, Herzzentrum Ludwigshafen, Ludwigshafen, Germany</affiliation><affiliation>Herzzentrum Ludwigshafen, Department of Cardiology, Bremserstrasse 79, D‐67063 Ludwigshafen,Germany.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Stefan</namePart><namePart type="family">Schuster</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Cardiology, St. Antonius Hospital, Kleve, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Rudolf</namePart><namePart type="family">Schiele</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Cardiology, Herzzentrum Ludwigshafen, Ludwigshafen, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Karlheinz</namePart><namePart type="family">Seidl</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Cardiology, Herzzentrum Ludwigshafen, Ludwigshafen, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Thomas</namePart><namePart type="family">Voigtländer</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Cardiology, Johannes Gutenberg Universität, Mainz, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jürgen</namePart><namePart type="family">Meyer</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Cardiology, Johannes Gutenberg Universität, Mainz, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Karl E.</namePart><namePart type="family">Hauptmann</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Cardiology, Krankenhaus der Barmherzigen Brüder, Trier, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Martin</namePart><namePart type="family">Gottwik</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Cardiology, Städtisches Klinikum, Nürnberg, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Gunther</namePart><namePart type="family">Berg</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Cardiology, Universitätskliniken, Homburg/Saar, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Thomas</namePart><namePart type="family">Kunz</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Cardiology, Winterbergkliniken, Saarbrücken, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Ulf</namePart><namePart type="family">Gieseler</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Cardiology, Diakonissenkrankenhaus, Speyer, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Michael</namePart><namePart type="family">Jakob</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Cardiology, Knappschaftskrankenhaus, Sulzbach, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jochen</namePart><namePart type="family">Senges</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Cardiology, Herzzentrum Ludwigshafen, Ludwigshafen, Germany</affiliation><description>for the Maximal Individual Therapy in Acute Myocardial Infarction (MITRA) Study Group</description><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>John Wiley & Sons, Inc.</publisher><place><placeTerm type="text">New York</placeTerm></place><dateIssued encoding="w3cdtf">1999-02</dateIssued><dateCaptured encoding="w3cdtf">1998-05-11</dateCaptured><dateValid encoding="w3cdtf">1998-09-02</dateValid><copyrightDate encoding="w3cdtf">1999</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="tables">3</extent><extent unit="references">36</extent><extent unit="words">5625</extent></physicalDescription><abstract lang="en">The benefit of primary angioplasty in patients with acute myocardial infarction (AMI) and contraindications for thrombolysis compared to a conservative regimen is still unclear. Out of 5,869 patients with AMI registered by the MITRA trial, 337 (5.7%) patients had at least one strong contraindication for thrombolytic therapy. Out of these 337 patients 46 (13.6%) were treated with primary angioplasty and 276 (86.4%) were treated conservatively. Patients treated conservatively were older (70 years vs. 60 years; P = 0.001), had a higher rate of a history with chronic heart failure (14.8% vs. 4.4%; P = 0.053), a higher heart rate at admission (86 beats/min vs. 74 beats/min; P = 0.001), and a higher prevalence of diabetes mellitus (27.1% vs. 12.8%; P = 0.056). Patients treated with primary angioplasty received more often aspirin (91.3% vs. 74.6%; P = 0.012), β‐blockers (60.9% vs. 46.1%; P = 0.062), angiotensin converting enzyme (ACE) inhibitors (71.7% vs. 44%; P = 0.001), and the so‐called optimal adjunctive medication (54.4% vs. 32.3%; P = 0.004). Hospital mortality was significantly lower in patients who received primary angioplasty (univariate: 2.2% vs. 24.7%; P = 0.001; multivariate: OR = 0.46; P = 0.0230). In patients with AMI and contraindications for thrombolytic therapy, primary angioplasty was associated with a significantly lower mortality compared to conservative treatment. Therefore, hospitals without the facilities to perform primary angioplasty should try to refer such patients to centers with the facilities for such a service, if this is possible in an acceptable time.Cathet. Cardiovasc. Intervent. 46:127–133, 1999. © 1999 Wiley‐Liss, Inc.</abstract><note type="funding">Zeneca</note><note type="funding">Bristol Myers‐Squibb</note><note type="funding">Ministerium für Gesundheit</note><note type="funding">Arbeit</note><note type="funding">Soziales des Landes Rheinland‐Pfalz</note><note type="funding">Landesversicherungsanstalt Rheinland‐Pfalz</note><note type="funding">Barmer und Betriebskrankenkassen Rheinland‐Pfalz</note><subject lang="en"><genre>keywords</genre><topic>myocardial infarction</topic><topic>primary angioplasty</topic><topic>thrombolysis</topic><topic>contraindication</topic></subject><relatedItem type="host"><titleInfo><title>Catheterization and Cardiovascular Interventions</title></titleInfo><titleInfo type="abbreviated"><title>Cathet. Cardiovasc. Intervent.</title></titleInfo><genre type="journal">journal</genre><subject><genre>article-category</genre><topic>Original Study</topic></subject><identifier type="ISSN">1522-1946</identifier><identifier type="eISSN">1522-726X</identifier><identifier type="DOI">10.1002/(ISSN)1522-726X</identifier><identifier type="PublisherID">CCD</identifier><part><date>1999</date><detail type="volume"><caption>vol.</caption><number>46</number></detail><detail type="issue"><caption>no.</caption><number>2</number></detail><extent unit="pages"><start>127</start><end>133</end><total>7</total></extent></part></relatedItem><relatedItem type="preceding"><titleInfo><title>Catheterization and Cardiovascular Diagnosis</title></titleInfo><identifier type="ISSN">0098-6569</identifier><identifier type="ISSN">1097-0304</identifier><part><date point="end">1998</date><detail type="volume"><caption>last vol.</caption><number>45</number></detail><detail type="issue"><caption>last no.</caption><number>4</number></detail></part></relatedItem><identifier type="istex">E70582777FF26D6B2D3A057AF1048B70BB094687</identifier><identifier type="DOI">10.1002/(SICI)1522-726X(199902)46:2<127::AID-CCD2>3.0.CO;2-G</identifier><identifier type="ArticleID">CCD2</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 1999 Wiley‐Liss, Inc.</accessCondition><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>John Wiley & Sons, Inc.</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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