Long-term prognosis of patency of infarct-related coronary artery after thrombolytic treatment in acute myocardial infarction. Collaborative Research Group on Thrombolysis.
OBJECTIVE
To investigate the long-term prognostic influence of patency of the infarct-related coronary artery.


METHODS
One thousand two hundred and sixty seven cases of acute myocardial infarction with thrombolytic treatment between July 1991 and January 1995 in 36 collaborative hospitals were followed-up after discharge with a total follow-up rate of 84.5%. Patency of infarct-related coronary artery was assessed by uniform clinical criteria. Eight hundred and forty three patients with patency were followed up for 16.0 +/- 10.4 months and 424 patients without patency for 19.2 +/- 12.22. Death or up to the end of March, 1995 was used as the end point.


RESULTS
Comparisons of patients with patent versus nonpatent infarct-related coronary artery during follow-up showed: (1) Cardiac death rate was 2.85% in patients with patency while 4.72% in those without patency (logrank test, P > 0.1). (2) Three-year survival rates calculated by Kaplan-Meier curve were 91.6% and 73.9% respectively (logrank test, P < 0.001). (3) Incidence of reinfarction were 5.7% and 5.9% respectively (P < 0.05). (4) Patients with class III-IV NYHA cardiac function occurred in 11.3% and 17.9% respectively (P < 0.01). (5) By Cox regression model analysis patency of infarct-related coronary artery, recurrent infarction, age and infarct sites were independent prognostic factors. Survival probability increased by 33.5% in patients with patency compared to those without patency.


CONCLUSIONS
It is evident that patency of infarct-related coronary artery could improve long-term survival.
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000401:mortality; D011379:Prognosis; D016016:Proportional Hazards Models; D015996:Survival Rate; D015912:Thrombolytic Therapy; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use*; D014654:Vascular Patency
D014568:Urokinase-Type Plasminogen Activator