Clinical course and left ventricular function in patients with acute myocardial infarction following delayed recanalization of infarct-related artery.
The effect of delayed recanalisation of the infarct related artery on clinical course and left ventricular functions was studied in 23 patients with acute myocardial infarction (Group 2). Another 82 patients with acute myocardial infarction served as controls: 48 patients with immediate recanalisation of the infarct related artery following intracoronary thrombolytic therapy (Group 1) and 34 patients with unsuccessful thrombolysis with the artery remaining occluded on repeat angiography (Group 3). Baseline clinical characteristics and left ventricular ejection fractions in the three groups did not differ statistically. Following intracoronary thrombolysis the clinical features and left ventricular functions in the three groups, respectively were as follows: post infarction angina--45.8%, 13.1% and 11.8% (1 vs. 2 and 3, P < 0.05); reinfarction--29.2%, 8.7% and 11.8% (1 vs. 2 and 3, P < 0.05); mortality--0%, 0% and 11.8% (1 and 2 vs. 3; P < 0.05); aneurysm--16.7%, 21.7% and 52.9% (1 and 2 vs. 3, P < 0.05); heart failure--20.8%, 21.7% and 47.1% (1 and 2 vs. 3, P < 0.05). Left ventricular ejection fractions on the second and on days 10-14 were, respectively, 47.6 +/- 1.1%, 42.8 +/- 1.1% and 39.2 +/- 1.6% (1 vs. 2 and 3, P < 0.05) and --52.1 +/- 1.0%, 48.9 +/- 1.1% and 44.3 +/- 1.5% (1 and 2 vs. 3, P < 0.05). Thus following delayed recanalisation of the infarct related artery the clinical course and left ventricular function improved significantly in comparison to patients without recanalisation.
Iosseliani
D G
DG
Department of Emergency and Interventional Cardiology, Bakulev's Institute of Cardiovascular Surgery, Moscow, Russian Federation.
Inoyatova
I I
II
Bhattacharya
P K
PK
Yarlikova
E I
EI
D000328:Adult; D000465:Algorithms; D017023:Coronary Angiography; D003402:Creatine Kinase / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology*; D005996:Nitroglycerin / Q000627:therapeutic use; D013300:Streptokinase / Q000627:therapeutic use; D013318:Stroke Volume / Q000187:drug effects; D015912:Thrombolytic Therapy; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000187:drug effects*
D003402:Creatine Kinase; D013300:Streptokinase; D005996:Nitroglycerin