Effects on the signal-averaged electrocardiogram of opening the coronary artery by thrombolytic therapy or percutaneous transluminal coronary angioplasty during acute myocardial infarction.
One hundred twenty-nine patients were retrospectively analyzed and divided into 3 groups according to (1) the presence of a patent artery obtained either spontaneously or after thrombolytic therapy but without percutaneous transluminal coronary angioplasty (PTCA) (group I, n = 83), (2) the presence of a patent artery after opening by PTCA (group II, n = 29), or (3) absence of reperfusion despite thrombolytic therapy or PTCA (group III, n = 17). Thrombolytic therapy was given within 4 hours after onset of symptoms (mean 2.5 +/- 1.0 hours) and PTCA was performed within 24 hours after the onset of symptoms (mean 6 +/- 6 hours). Signal averaging was performed within 24 hours after cardiac catheterization. An abnormal signal-averaged electrocardiogram was present in 10 of 83 (12%) group I, 9 of 29 (31%) group II and 7 of 17 (41%) group III patients (p < 0.05 group I vs II, p < 0.01 group I vs III, no statistical difference group II vs III). Therefore, in contrast to reperfusion by thrombolytic therapy the incidence of abnormalities on the signal-averaged electrocardiogram early after myocardial infarction is not reduced by an early opening of the culprit vessel by PTCA.
de Chillou
C
C
Department of Cardiology, University of Limburg Academic Hospital, Maastricht, The Netherlands.
Rodriguez
L M
LM
Doevendans
P
P
Loutsidis
K
K
van den Dool
A
A
Metzger
J
J
Bär
F W
FW
Smeets
J L
JL
Wellens
H J
HJ
D015906:Angioplasty, Balloon, Coronary; D006328:Cardiac Catheterization; D003327:Coronary Disease / Q000453:epidemiology / Q000628:therapy*; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D012189:Retrospective Studies; D012815:Signal Processing, Computer-Assisted; D013318:Stroke Volume / Q000502:physiology; D015912:Thrombolytic Therapy; D013997:Time Factors; D014654:Vascular Patency / Q000502:physiology