The short- and long-term prognosis for acute myocardial infarction after emergency coronary angioplasty.
The short- and long-term prognosis for acute myocardial infarction after reperfusion was examined in 175 patients with successful emergency angioplasty and in 29 failed cases. During hospitalization, more cardiac events occurred in the failed group than in the successful group (58.6% versus 12.6%; p < 0.001), especially cardiac death and coronary bypass surgery (27.6% versus 4.0%, and 41.4% versus 4.6%; p < 0.001, respectively). The only difference found in the incidence of post-discharge cardiac events was a higher frequency of cardiac death in the failed group (9.5% versus 1.2%; p < 0.02). The failed group also had a lower cumulative survival rate at 5 years (69.0% versus 95.3%; p < 0.01). Cox proportional hazard analysis showed that the results of angioplasty, cardiac index, peak creatine kinase level, and the number of diseased vessels were significant independent variables for the prediction of subsequent cardiac death at long-term follow-up. Thus, successful reperfusion by emergency angioplasty improved the prognosis of acute myocardial infarction, even when other important variables were considered.
Sumii
K
K
Department of Cardiology, Tsuchiya General Hospital, Hiroshima, Japan.
Hayashi
Y
Y
Oka
Y
Y
Taniguchi
C
C
Maeda
Y
Y
Watanabe
M
M
Yamamoto
H
H
Tsuchiya
T
T
Sasaki
H
H
Yamakido
M
M
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000706:statistics & numerical data; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D011379:Prognosis; D016019:Survival Analysis