Improved survival up to four years after early coronary thrombolysis.
The long-term prognosis after thrombolytic therapy in patients with acute myocardial infarction (AMI) is unknown. This question was investigated in a 4-year follow-up study of 227 patients. According to the status of reperfusion at the end of the acute catheterization, the patients were divided into a patent (n = 171) and an occluded (n = 56) group. Both hospital and 4-year mortality rates were significantly reduced in the patent group by 13 and 14%, respectively (p less than or equal to 0.005 for both). Baseline variables known to be important for prognosis did not differ between the 2 groups. Patients with a patent infarct artery who underwent early acute coronary artery bypass grafting (CABG) had a greater survival (p less than 0.10) and better left ventricular function (p less than 0.01) than did patients with a patent infarct artery who did not undergo CABG. This difference was associated with a lower frequency of fatal reinfarction and cardiogenic shock in the CABG group. Thus, survival is improved up to 4 years after successful thrombolysis and appears to be further enhanced by early CABG.
Mathey
D G
DG
Department of Cardiology, University Hospital Eppendorf, Hamburg, West Germany.
Schofer
J
J
Sheehan
F H
FH
Krebber
H J
HJ
Justen
M
M
Rodewald
G
G
Dodge
H T
HT
Bleifeld
W
W
D006328:Cardiac Catheterization; D001026:Coronary Artery Bypass; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D012008:Recurrence; D013318:Stroke Volume; D013997:Time Factors; D014654:Vascular Patency
D005343:Fibrinolytic Agents