[ST-segment and myocardial enzymes evolution during myocardial infarction after fibrinolysis therapy and its relation with postinfarction angina, Killip class and mortality in intensive unit care].
BACKGROUND
The prognostic value of enzyme peaks, the sum of the ST segment and reperfusion arrythmias during myocardial infarction remains unclear.


OBJECTIVE
The aim of this study was to relate the early enzymatic peaks, the sum of the ST segment and reperfusion arrythmias after thrombolytic therapy with postinfarction angina, Killip class and mortality during the acute phase of myocardial infarction.


METHODS
Of 187 patients receiving fibrinolytic therapy, 169 were consecutively and prospectively included in the study. The following myocardial enzymes were determined: CK, MB, TGO, LDH. Electrocardiograms were performed prior to and 2, 6, 12 and 24 hours after the administration of the fibrinolytic drug.


RESULTS
The mean age of the patients was 60.12 +/- 11.3 years, with 138 (81.7%) being males. Myocardial infarction was anterior in 74 (43.7%) and inferior in 95 cases (56.3%). Reperfusion arrythmias were observed in 65 cases (38.5%). One hundred thirty-one (77.5%) were Killip class I, 12 (7.1%) presented postinfarction angina, and 8 (4.7%) died. A peak was observed in MB at 6 hours in cases of anterior myocardial infarction and the sum of the ST segment decreased less than 50% in the first 2 hours. No statistically significant correlation was observed between the enzymatic peaks, the reperfusion arrythmias, Killip class, postinfarction angina or early mortality. The greater the ST segment sum, the greater the severity according to the Killip class. On multivariate analysis no model was found to be related to postinfarction angina. However, age was related to mortality and sex and age were associated with heart failure.


CONCLUSIONS
In our population, the variables studied were not found to be useful to determine the prognosis during the early phase of acute myocardial infarction.
Fernández-Bergés
D
D
Unidad de Cuidados Intensivos, Hospital Comarcal Don Benito-Villanueva, Badajoz. polonibo@wanadoo.es
Cerdeyra Lombardini
C
C
Palomo Cobos
L
L
Alzugaray Fraga
R
R
Veiga González
M
M
Corcho Sánchez
G
G
Daud Guido
S
S
José Zaro Bastanzuri
M
M
Córdoba López
A
A
Monterrubio Villar
J
J
D000368:Aged; D003422:Critical Care; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000201:enzymology / Q000401:mortality / Q000503:physiopathology*; D015428:Myocardial Reperfusion Injury / Q000201:enzymology / Q000401:mortality / Q000503:physiopathology; D009206:Myocardium / Q000201:enzymology*; D011446:Prospective Studies; D015912:Thrombolytic Therapy