A randomized double-blind trial of intravenous trimetazidine as adjunctive therapy to primary angioplasty for acute myocardial infarction
Background: Despite high patency rates, primary angioplasty for myocardial infarction does not necessarily result in optimal myocardial reperfusion and limitation of infarct size. Experimentally, trimetazidine limits infarct size, decreases platelet aggregation, and reduces leukocyte influx into the...
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| Veröffentlicht in: | International journal of cardiology 2001-02, Vol.77 (2), p.263-273 |
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| creator | Steg, Ph.Gabriel Grollier, Gilles Gallay, Pierre Morice, Marie-Claude Karrillon, Gaëtan J. Benamer, Hakim Kempf, Christian Laperche, Thierry Arnaud, Pierre Sellier, Philippe Bourguignon, Christian Harpey, Catherine |
| description | Background: Despite high patency rates, primary angioplasty for myocardial infarction does not necessarily result in optimal myocardial reperfusion and limitation of infarct size. Experimentally, trimetazidine limits infarct size, decreases platelet aggregation, and reduces leukocyte influx into the infarct zone. To assess trimetazidine as adjunctive therapy to primary angioplasty for acute myocardial infarction a prospective, double-blind, placebo-controlled pilot trial was performed.
Methods: 94 patients with acute myocardial infarction were randomized to receive trimetazidine (40 mg bolus followed by 60 mg/day intravenously for 48 h) (
n=44) or placebo (
n=50), starting before recanalization of the infarct vessel by primary angioplasty. Patients underwent continuous ST-segment monitoring to assess return of ST-segment deviation to baseline and presence of ST-segment exacerbation at the time of vessel recanalization. Infarct size was measured enzymatically from serial myoglobin measurements. Left ventricular angiography was performed before treatment and repeated at day 14.
Results: Blinded ST segment analysis showed that despite higher initial ST deviation from baseline in the trimetazidine group (355 (32) vs. 278 (29) μV,
P=0.07), there was an earlier and more marked return towards baseline within the first 6 h than in the placebo group (
P=0.014) (change: 245 (30) vs. 156 (31) μV respectively,
P=0.044). There was a trend towards less frequent exacerbation of ST deviation at the time of recanalization in the trimetazidine group (23.3 vs. 42.2%,
P=0.11). There was no difference in left ventricular wall motion at day 14, or in enzymatic infarct size. There was no side effect from treatment. Clinical outcomes were similar between groups.
Conclusion: Trimetazidine was safe and led to earlier resolution of ST-segment elevation in patients treated by primary angioplasty for acute myocardial infarction. |
| doi_str_mv | 10.1016/S0167-5273(00)00443-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_70631324</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0167527300004435</els_id><sourcerecordid>70631324</sourcerecordid><originalsourceid>FETCH-LOGICAL-c455t-340e0e66c51cf0441e1e982348705996d7bd1f83a251b54a597eb98f3e8475fe3</originalsourceid><addsrcrecordid>eNqFkc2KFDEUhYMoTs_oIygBQcZFaVKV1M9KhsE_GHChrsOt5EYzVCVtkmroeQPf2tR0MS7dJBC-c3PPOYS84OwtZ7x9960cXSXrrrlk7A1jQjSVfER2vO9ExTspHpPdA3JGzlO6ZYUahv4pOeOc9zUf-I78uaIRvAmzu0NDTVjGCatxct7QHB1MNFjqfI5wQB-WtD7OmOHOGeeRQqJgbhevszsgzb8wwv5Ic6D7gkE8UvA_XdhPkPKR2hAp6CUjnY9BQzTreOctxCIP_hl5YmFK-Hy7L8iPjx--X3-ubr5--nJ9dVNpIWWuGsGQYdtqybUtrjlyHPq6EX3H5DC0phsNt30DteSjFCCHDsehtw32opMWmwvy-jR3H8PvBVNWs0sapwk8FoeqY23Dm1oUUJ5AHUNKEa3aXCnO1NqBuu9ArQErxtR9B0oW3cvtg2Wc0fxTbaEX4NUGQNIw2VKAdumBGxiT_Uq9P1FYwjg4jCpph16jcRF1Via4_yzyF_9BpZs</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>70631324</pqid></control><display><type>article</type><title>A randomized double-blind trial of intravenous trimetazidine as adjunctive therapy to primary angioplasty for acute myocardial infarction</title><source>Elsevier ScienceDirect Journals Complete - AutoHoldings</source><source>MEDLINE</source><creator>Steg, Ph.Gabriel ; Grollier, Gilles ; Gallay, Pierre ; Morice, Marie-Claude ; Karrillon, Gaëtan J. ; Benamer, Hakim ; Kempf, Christian ; Laperche, Thierry ; Arnaud, Pierre ; Sellier, Philippe ; Bourguignon, Christian ; Harpey, Catherine</creator><creatorcontrib>Steg, Ph.Gabriel ; Grollier, Gilles ; Gallay, Pierre ; Morice, Marie-Claude ; Karrillon, Gaëtan J. ; Benamer, Hakim ; Kempf, Christian ; Laperche, Thierry ; Arnaud, Pierre ; Sellier, Philippe ; Bourguignon, Christian ; Harpey, Catherine ; for the LIST Study Group ; LIST Study Group</creatorcontrib><description>Background: Despite high patency rates, primary angioplasty for myocardial infarction does not necessarily result in optimal myocardial reperfusion and limitation of infarct size. Experimentally, trimetazidine limits infarct size, decreases platelet aggregation, and reduces leukocyte influx into the infarct zone. To assess trimetazidine as adjunctive therapy to primary angioplasty for acute myocardial infarction a prospective, double-blind, placebo-controlled pilot trial was performed.
Methods: 94 patients with acute myocardial infarction were randomized to receive trimetazidine (40 mg bolus followed by 60 mg/day intravenously for 48 h) (
n=44) or placebo (
n=50), starting before recanalization of the infarct vessel by primary angioplasty. Patients underwent continuous ST-segment monitoring to assess return of ST-segment deviation to baseline and presence of ST-segment exacerbation at the time of vessel recanalization. Infarct size was measured enzymatically from serial myoglobin measurements. Left ventricular angiography was performed before treatment and repeated at day 14.
Results: Blinded ST segment analysis showed that despite higher initial ST deviation from baseline in the trimetazidine group (355 (32) vs. 278 (29) μV,
P=0.07), there was an earlier and more marked return towards baseline within the first 6 h than in the placebo group (
P=0.014) (change: 245 (30) vs. 156 (31) μV respectively,
P=0.044). There was a trend towards less frequent exacerbation of ST deviation at the time of recanalization in the trimetazidine group (23.3 vs. 42.2%,
P=0.11). There was no difference in left ventricular wall motion at day 14, or in enzymatic infarct size. There was no side effect from treatment. Clinical outcomes were similar between groups.
Conclusion: Trimetazidine was safe and led to earlier resolution of ST-segment elevation in patients treated by primary angioplasty for acute myocardial infarction.</description><identifier>ISSN: 0167-5273</identifier><identifier>EISSN: 1874-1754</identifier><identifier>DOI: 10.1016/S0167-5273(00)00443-5</identifier><identifier>PMID: 11182191</identifier><identifier>CODEN: IJCDD5</identifier><language>eng</language><publisher>Shannon: Elsevier Ireland Ltd</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Angioplasty ; Angioplasty, Balloon, Coronary ; Antianginal agents. Coronary vasodilator agents ; Biological and medical sciences ; Cardiovascular system ; Chemotherapy, Adjuvant ; Coronary Angiography ; Double-Blind Method ; Female ; Humans ; Infusions, Intravenous ; Male ; Medical sciences ; Middle Aged ; Myocardial infarction ; Myocardial Infarction - drug therapy ; Myocardial Infarction - therapy ; Pharmacology. Drug treatments ; Reperfusion ; ST-segment ; Trimetazidine ; Trimetazidine - administration & dosage ; Trimetazidine - therapeutic use ; Vasodilator Agents - administration & dosage ; Vasodilator Agents - therapeutic use</subject><ispartof>International journal of cardiology, 2001-02, Vol.77 (2), p.263-273</ispartof><rights>2001 Elsevier Science Ireland Ltd</rights><rights>2001 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-340e0e66c51cf0441e1e982348705996d7bd1f83a251b54a597eb98f3e8475fe3</citedby><cites>FETCH-LOGICAL-c455t-340e0e66c51cf0441e1e982348705996d7bd1f83a251b54a597eb98f3e8475fe3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0167-5273(00)00443-5$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3548,27922,27923,45993</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=900581$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11182191$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Steg, Ph.Gabriel</creatorcontrib><creatorcontrib>Grollier, Gilles</creatorcontrib><creatorcontrib>Gallay, Pierre</creatorcontrib><creatorcontrib>Morice, Marie-Claude</creatorcontrib><creatorcontrib>Karrillon, Gaëtan J.</creatorcontrib><creatorcontrib>Benamer, Hakim</creatorcontrib><creatorcontrib>Kempf, Christian</creatorcontrib><creatorcontrib>Laperche, Thierry</creatorcontrib><creatorcontrib>Arnaud, Pierre</creatorcontrib><creatorcontrib>Sellier, Philippe</creatorcontrib><creatorcontrib>Bourguignon, Christian</creatorcontrib><creatorcontrib>Harpey, Catherine</creatorcontrib><creatorcontrib>for the LIST Study Group</creatorcontrib><creatorcontrib>LIST Study Group</creatorcontrib><title>A randomized double-blind trial of intravenous trimetazidine as adjunctive therapy to primary angioplasty for acute myocardial infarction</title><title>International journal of cardiology</title><addtitle>Int J Cardiol</addtitle><description>Background: Despite high patency rates, primary angioplasty for myocardial infarction does not necessarily result in optimal myocardial reperfusion and limitation of infarct size. Experimentally, trimetazidine limits infarct size, decreases platelet aggregation, and reduces leukocyte influx into the infarct zone. To assess trimetazidine as adjunctive therapy to primary angioplasty for acute myocardial infarction a prospective, double-blind, placebo-controlled pilot trial was performed.
Methods: 94 patients with acute myocardial infarction were randomized to receive trimetazidine (40 mg bolus followed by 60 mg/day intravenously for 48 h) (
n=44) or placebo (
n=50), starting before recanalization of the infarct vessel by primary angioplasty. Patients underwent continuous ST-segment monitoring to assess return of ST-segment deviation to baseline and presence of ST-segment exacerbation at the time of vessel recanalization. Infarct size was measured enzymatically from serial myoglobin measurements. Left ventricular angiography was performed before treatment and repeated at day 14.
Results: Blinded ST segment analysis showed that despite higher initial ST deviation from baseline in the trimetazidine group (355 (32) vs. 278 (29) μV,
P=0.07), there was an earlier and more marked return towards baseline within the first 6 h than in the placebo group (
P=0.014) (change: 245 (30) vs. 156 (31) μV respectively,
P=0.044). There was a trend towards less frequent exacerbation of ST deviation at the time of recanalization in the trimetazidine group (23.3 vs. 42.2%,
P=0.11). There was no difference in left ventricular wall motion at day 14, or in enzymatic infarct size. There was no side effect from treatment. Clinical outcomes were similar between groups.
Conclusion: Trimetazidine was safe and led to earlier resolution of ST-segment elevation in patients treated by primary angioplasty for acute myocardial infarction.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Angioplasty</subject><subject>Angioplasty, Balloon, Coronary</subject><subject>Antianginal agents. Coronary vasodilator agents</subject><subject>Biological and medical sciences</subject><subject>Cardiovascular system</subject><subject>Chemotherapy, Adjuvant</subject><subject>Coronary Angiography</subject><subject>Double-Blind Method</subject><subject>Female</subject><subject>Humans</subject><subject>Infusions, Intravenous</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myocardial infarction</subject><subject>Myocardial Infarction - drug therapy</subject><subject>Myocardial Infarction - therapy</subject><subject>Pharmacology. Drug treatments</subject><subject>Reperfusion</subject><subject>ST-segment</subject><subject>Trimetazidine</subject><subject>Trimetazidine - administration & dosage</subject><subject>Trimetazidine - therapeutic use</subject><subject>Vasodilator Agents - administration & dosage</subject><subject>Vasodilator Agents - therapeutic use</subject><issn>0167-5273</issn><issn>1874-1754</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkc2KFDEUhYMoTs_oIygBQcZFaVKV1M9KhsE_GHChrsOt5EYzVCVtkmroeQPf2tR0MS7dJBC-c3PPOYS84OwtZ7x9960cXSXrrrlk7A1jQjSVfER2vO9ExTspHpPdA3JGzlO6ZYUahv4pOeOc9zUf-I78uaIRvAmzu0NDTVjGCatxct7QHB1MNFjqfI5wQB-WtD7OmOHOGeeRQqJgbhevszsgzb8wwv5Ic6D7gkE8UvA_XdhPkPKR2hAp6CUjnY9BQzTreOctxCIP_hl5YmFK-Hy7L8iPjx--X3-ubr5--nJ9dVNpIWWuGsGQYdtqybUtrjlyHPq6EX3H5DC0phsNt30DteSjFCCHDsehtw32opMWmwvy-jR3H8PvBVNWs0sapwk8FoeqY23Dm1oUUJ5AHUNKEa3aXCnO1NqBuu9ArQErxtR9B0oW3cvtg2Wc0fxTbaEX4NUGQNIw2VKAdumBGxiT_Uq9P1FYwjg4jCpph16jcRF1Via4_yzyF_9BpZs</recordid><startdate>20010201</startdate><enddate>20010201</enddate><creator>Steg, Ph.Gabriel</creator><creator>Grollier, Gilles</creator><creator>Gallay, Pierre</creator><creator>Morice, Marie-Claude</creator><creator>Karrillon, Gaëtan J.</creator><creator>Benamer, Hakim</creator><creator>Kempf, Christian</creator><creator>Laperche, Thierry</creator><creator>Arnaud, Pierre</creator><creator>Sellier, Philippe</creator><creator>Bourguignon, Christian</creator><creator>Harpey, Catherine</creator><general>Elsevier Ireland Ltd</general><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20010201</creationdate><title>A randomized double-blind trial of intravenous trimetazidine as adjunctive therapy to primary angioplasty for acute myocardial infarction</title><author>Steg, Ph.Gabriel ; Grollier, Gilles ; Gallay, Pierre ; Morice, Marie-Claude ; Karrillon, Gaëtan J. ; Benamer, Hakim ; Kempf, Christian ; Laperche, Thierry ; Arnaud, Pierre ; Sellier, Philippe ; Bourguignon, Christian ; Harpey, Catherine</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c455t-340e0e66c51cf0441e1e982348705996d7bd1f83a251b54a597eb98f3e8475fe3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Angioplasty</topic><topic>Angioplasty, Balloon, Coronary</topic><topic>Antianginal agents. Coronary vasodilator agents</topic><topic>Biological and medical sciences</topic><topic>Cardiovascular system</topic><topic>Chemotherapy, Adjuvant</topic><topic>Coronary Angiography</topic><topic>Double-Blind Method</topic><topic>Female</topic><topic>Humans</topic><topic>Infusions, Intravenous</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Myocardial infarction</topic><topic>Myocardial Infarction - drug therapy</topic><topic>Myocardial Infarction - therapy</topic><topic>Pharmacology. Drug treatments</topic><topic>Reperfusion</topic><topic>ST-segment</topic><topic>Trimetazidine</topic><topic>Trimetazidine - administration & dosage</topic><topic>Trimetazidine - therapeutic use</topic><topic>Vasodilator Agents - administration & dosage</topic><topic>Vasodilator Agents - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Steg, Ph.Gabriel</creatorcontrib><creatorcontrib>Grollier, Gilles</creatorcontrib><creatorcontrib>Gallay, Pierre</creatorcontrib><creatorcontrib>Morice, Marie-Claude</creatorcontrib><creatorcontrib>Karrillon, Gaëtan J.</creatorcontrib><creatorcontrib>Benamer, Hakim</creatorcontrib><creatorcontrib>Kempf, Christian</creatorcontrib><creatorcontrib>Laperche, Thierry</creatorcontrib><creatorcontrib>Arnaud, Pierre</creatorcontrib><creatorcontrib>Sellier, Philippe</creatorcontrib><creatorcontrib>Bourguignon, Christian</creatorcontrib><creatorcontrib>Harpey, Catherine</creatorcontrib><creatorcontrib>for the LIST Study Group</creatorcontrib><creatorcontrib>LIST Study Group</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Steg, Ph.Gabriel</au><au>Grollier, Gilles</au><au>Gallay, Pierre</au><au>Morice, Marie-Claude</au><au>Karrillon, Gaëtan J.</au><au>Benamer, Hakim</au><au>Kempf, Christian</au><au>Laperche, Thierry</au><au>Arnaud, Pierre</au><au>Sellier, Philippe</au><au>Bourguignon, Christian</au><au>Harpey, Catherine</au><aucorp>for the LIST Study Group</aucorp><aucorp>LIST Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A randomized double-blind trial of intravenous trimetazidine as adjunctive therapy to primary angioplasty for acute myocardial infarction</atitle><jtitle>International journal of cardiology</jtitle><addtitle>Int J Cardiol</addtitle><date>2001-02-01</date><risdate>2001</risdate><volume>77</volume><issue>2</issue><spage>263</spage><epage>273</epage><pages>263-273</pages><issn>0167-5273</issn><eissn>1874-1754</eissn><coden>IJCDD5</coden><abstract>Background: Despite high patency rates, primary angioplasty for myocardial infarction does not necessarily result in optimal myocardial reperfusion and limitation of infarct size. Experimentally, trimetazidine limits infarct size, decreases platelet aggregation, and reduces leukocyte influx into the infarct zone. To assess trimetazidine as adjunctive therapy to primary angioplasty for acute myocardial infarction a prospective, double-blind, placebo-controlled pilot trial was performed.
Methods: 94 patients with acute myocardial infarction were randomized to receive trimetazidine (40 mg bolus followed by 60 mg/day intravenously for 48 h) (
n=44) or placebo (
n=50), starting before recanalization of the infarct vessel by primary angioplasty. Patients underwent continuous ST-segment monitoring to assess return of ST-segment deviation to baseline and presence of ST-segment exacerbation at the time of vessel recanalization. Infarct size was measured enzymatically from serial myoglobin measurements. Left ventricular angiography was performed before treatment and repeated at day 14.
Results: Blinded ST segment analysis showed that despite higher initial ST deviation from baseline in the trimetazidine group (355 (32) vs. 278 (29) μV,
P=0.07), there was an earlier and more marked return towards baseline within the first 6 h than in the placebo group (
P=0.014) (change: 245 (30) vs. 156 (31) μV respectively,
P=0.044). There was a trend towards less frequent exacerbation of ST deviation at the time of recanalization in the trimetazidine group (23.3 vs. 42.2%,
P=0.11). There was no difference in left ventricular wall motion at day 14, or in enzymatic infarct size. There was no side effect from treatment. Clinical outcomes were similar between groups.
Conclusion: Trimetazidine was safe and led to earlier resolution of ST-segment elevation in patients treated by primary angioplasty for acute myocardial infarction.</abstract><cop>Shannon</cop><pub>Elsevier Ireland Ltd</pub><pmid>11182191</pmid><doi>10.1016/S0167-5273(00)00443-5</doi><tpages>11</tpages></addata></record> |
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| ispartof | International journal of cardiology, 2001-02, Vol.77 (2), p.263-273 |
| issn | 0167-5273 1874-1754 |
| language | eng |
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| source | Elsevier ScienceDirect Journals Complete - AutoHoldings; MEDLINE |
| subjects | Adolescent Adult Aged Aged, 80 and over Angioplasty Angioplasty, Balloon, Coronary Antianginal agents. Coronary vasodilator agents Biological and medical sciences Cardiovascular system Chemotherapy, Adjuvant Coronary Angiography Double-Blind Method Female Humans Infusions, Intravenous Male Medical sciences Middle Aged Myocardial infarction Myocardial Infarction - drug therapy Myocardial Infarction - therapy Pharmacology. Drug treatments Reperfusion ST-segment Trimetazidine Trimetazidine - administration & dosage Trimetazidine - therapeutic use Vasodilator Agents - administration & dosage Vasodilator Agents - therapeutic use |
| title | A randomized double-blind trial of intravenous trimetazidine as adjunctive therapy to primary angioplasty for acute myocardial infarction |
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