Long-term prognosis after thrombolytic therapy for acute myocardial infarction.
In order to clarify the relationship between the patency of the infarcted arteries and subsequent long-term prognosis after thrombolytic therapy, we evaluated 116 patients with acute myocardial infarction treated with intracoronary (112 patients) or intravenous (four patients) urokinase. Patients treated with angioplasty after thrombolysis were excluded. The infarcted vessel was recanalized in 52 patients (patent group) and was not in the remaining 64 patients (occluded group). Five-year and 8-year follow up was conducted in 91% and 81% of the patients, respectively. The 1-, 5- and 8-year survival rate for the patent and occluded group was 91.8 and 80.9%, 80.8 and 79.2%, and 75.9 and 75.6%, respectively. The survival rate in the patent group tended to be higher than that in the occluded group up to 4 years. However, after 5 years, both groups showed similar survival rates. Therefore, reopening of the infarcted arteries with thrombolysis was not an independent predictor for late cardiac death (Cox regression analysis).
Department of Internal Medicine, Faculty of Medicine, Kyoto University, Japan.
K
K
Kosuga
R
R
Hattori
H
H
Eizawa
R
R
Inoue
H
H
Uchizumi
T
T
Aoyama
Y
Y
Yui
S
S
Tamaki
C
C
Kawai
S
S
Sasayama
D000368:Aged; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D015552:Injections, Intralesional; D007275:Injections, Intravenous; D015993:Life Tables; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D011379:Prognosis; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012189:Retrospective Studies; D015996:Survival Rate; D015912:Thrombolytic Therapy; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use*; D014654:Vascular Patency
D014568:Urokinase-Type Plasminogen Activator