title: Improved survival up to four years after early coronary thrombolysis.
abstract: 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.
authors.affiliation: Department of Cardiology, University Hospital Eppendorf, Hamburg, West Germany.
authors.forename: D G
authors.initials: DG
authors.lastname: Mathey
authors.forename: J
authors.initials: J
authors.lastname: Schofer
authors.forename: F H
authors.initials: FH
authors.lastname: Sheehan
authors.forename: H J
authors.initials: HJ
authors.lastname: Krebber
authors.forename: M
authors.initials: M
authors.lastname: Justen
authors.forename: G
authors.initials: G
authors.lastname: Rodewald
authors.forename: H T
authors.initials: HT
authors.lastname: Dodge
authors.forename: W
authors.initials: W
authors.lastname: Bleifeld
mesh_terms: 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
chemical_list: D005343:Fibrinolytic Agents