title: [In-hospital survival predictors in infarction patients undergoing fibrinolytic therapy].
abstract: OBJECTIVE
  To analyze the in-hospital predictors of survival in a population of infarcted patients submitted to the same therapeutic protocol that included IV streptokinase (SK) in the dose of 750,000 units.
  
  
  METHODS
  Three hundred and thirty two patients (mean age 55.6 +/- 10 years, 82.3% men) with acute myocardial infarction (AMI) were studied within six hours of onset of symptoms in a prospective and consecutive protocol. Using simple and multiple regression analysis, the following variables were selected for correlation with survival: LV ejection fraction by contrast ventriculography > 50%; CK-MB peak < or = 100 UI/1; male sex; invasive treatment (surgery or angioplasty); patent "culprit" coronary on cineangiography; age < or = 65 years; time interval between the onset of pain and the beginning of SK infusion < 3 hours; residual obstruction < 70% at the "culprit" coronary; inferior AMI location on ECG; absence of hypotension per-peri SK infusion, previous AMI, multivessel coronary artery disease and reinfarction.
  
  
  RESULTS
  By simple regression analysis, ejection fraction > 50% (p < 0.001), CK-MB peak < or = 100 UI/1 (p = 0.003), and the absence of hypotension (p < 0.001), previous AMI (p = 0.009), multivessel coronary artery disease (p = 0.02) and reinfarction (p = 0.049), correlated significantly with survival. By multiple regression analysis ejection fraction > 50% (p = 0.017) and the absence of hypotension (p < 0.01), multivessel coronary artery disease (p = 0.032) and reinfarction (p = 0.037) correlated independently with survival.
  
  
  CONCLUSIONS
  The data presented strongly support the concept of preventing atherosclerosis and maintaining myocardial viability using either direct measures such as recanalization, or indirect measures such prevention of hypotension and reinfarction.
authors.affiliation: Instituto de Moléstias Cardiovasculares, São José do Rio Preto.
authors.forename: J C
authors.initials: JC
authors.lastname: Nicolau
authors.forename: M A
authors.initials: MA
authors.lastname: Pinto
authors.forename: P R
authors.initials: PR
authors.lastname: Nogueira
authors.forename: A M
authors.initials: AM
authors.lastname: Lorga
authors.forename: J L
authors.initials: JL
authors.lastname: Jacob
authors.forename: S A
authors.initials: SA
authors.lastname: Garzon
mesh_terms: D000367:Age Factors; D000368:Aged; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies; D012044:Regression Analysis; D013300:Streptokinase / Q000627:therapeutic use*; D013318:Stroke Volume; D016019:Survival Analysis; D015912:Thrombolytic Therapy; D013997:Time Factors
chemical_list: D013300:Streptokinase
vernacular_title: Preditores da sobrevida intra-hospitalar em pacientes infartados submetidos à terapêutica fibrinolítica.