[Late thrombolysis and electrical stability in acute myocardial infarction. Role of the collateral flow].
We evaluated 249 patients (pts) with first acute myocardial infarction: 1. Pts without thrombolysis, n = 119, 2. Pts treated with thrombolysis within 6 hours following MI, n = 80 and 3. Pts treated with thrombolysis between 6-12 hours after MI. Arrhythmic events were evaluated during follow up. All underwent heart rate variability studies and coronary angiogram where anterograde flow (TIMI) and collateral flow (Rentrop scale 0-2 = poor collateral flow and 3 = good collateral flow) were determined. Pts in group 2 and 3 showed a better anterograde and collateral flow than group 1 (p < 0.001). A lower spectral power in the high frequency band and a higher ratio low/high frequency band were observed in group 1 (p < 0.05). Conjunctive consolidation analysis showed more malignant arrhythmias in TIMI 0-2 with poor collateral flow than TIMI 0-2 with good collateral flow (17/138-12.3% vs 0/14-0%). Kaplan Meier analysis was able to demonstrate more cardiac sudden death events in TIMI 0-2 with poor collateral flow than TIMI 0-2 with good collateral flow or TIMI 3 (x2 = 7.22, p = 0.028), independently of thrombolytic treatment.
Cossío-Aranda
J E
JE
Instituto Nacional de Cardiología Ignacio Chávez, México, D.F.
Lupi Herrera
E
E
González Hermosillo
J A
JA
Martínez Ríos
M A
MA
Kuri Alfaro
J
J
Villavicencio
R
R
Peña Duque
M A
MA
Cárdenas Loaeza
M
M
Rosas Peralta
M
M
Martínez Reding
J
J
Martínez Sánchez
C
C
González
H
H
Juárez
U
U
Solís de la Rosa
F
F
D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000503:physiopathology; D003097:Collateral Circulation; D015716:Electrocardiography, Ambulatory; D004594:Electrophysiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology*; D015912:Thrombolytic Therapy
Trombolisis tardía y estabilidad eléctrica en el infarto agudo del miocardio: importancia del flujo colateral.