[The efficacy and limitation of rescue coronary angioplasty for acute myocardial infarction].
Eighty one patients with acute transmural anterior myocardial infarction admitted to our hospital, from January, 1987 to February, 1991, were included in the present study. In 62 cases, reperfusion therapy was performed within 12 hours from the onset of chest pain. Forty nine patients underwent intracoronary thrombolysis, and in 16 patients (group RA) with failed thrombolysis (TIMI less than or equal to 1) percutaneous transluminal coronary angioplasty (PTCA) was performed as a "rescue" procedure. We studied the efficacy and limitation of rescue PTCA compared with direct PTCA (group DA, n = 13), intracoronary thrombolysis (group CT, n = 33) and conservative therapy without the above interventions (group N, n = 19). Initial reperfusion rate of intracoronary thrombolysis was 53% which was lower than group RA (88%) and group DA (100%) (p less than 0.05, p less than 0.01, respectively). Residual stenosis of infarct-related artery in the chronic phase (mean 28 +/- 7 days after initial intervention) in group CT was higher than group RA and group DA (p less than 0.01, p less than 0.01, respectively). LVEDVI in intervention groups (group CT, group RA, and group DA) were similar and significantly smaller than group N (p less than 0.05, p less than 0.05, and p less than 0.01, respectively). Ejection Fraction (EF) in intervention groups were significantly higher than group N. Regional wall motion of infarcted area in group CT and group DA were significantly better than group N (p less than 0.01, p less than 0.01, respectively). However, RWM in group RA was not significantly different compared with group N.(ABSTRACT TRUNCATED AT 250 WORDS)
Akiyama
T
T
Third Department of Internal Medicine, Toho University School of Medicine.
Tohma
M
M
D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000503:physiopathology / Q000628:therapy*; D015912:Thrombolytic Therapy; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use
D014568:Urokinase-Type Plasminogen Activator