Degree of activity at the onset of myocardial infarction and thrombolysis outcome.
BACKGROUND
The aim of this study was to evaluate the possible relationship between the degree of physical activity at the onset of myocardial infarction and thrombolysis outcome.


METHODS
A total of 351 consecutive patients, who underwent thrombolysis due to ST elevation acute myocardial infarction, were prospectively studied. Patients were classified into three groups according to a generally accepted scale: group I patients had experienced symptoms during exertion, group II when sitting and group III during sleep or when reclining.


RESULTS
There was a significantly increased chance of either intravenous thrombolysis effectiveness or cardiac survival probability with increasing physical activity at the onset of myocardial infarction. In particular, group I patients had a significantly higher incidence of complete ST-segment resolution (P<0.001 for both II vs. I and III vs. I groups) or TIMI 3 flow in the infarct-related artery (II vs. I: P=0.002, and III vs. I: P<0.001) and less compromised left ventricular function (P<0.001 for both II vs. I and III vs. I) by both univariate and multivariate analysis. Moreover, although the degree of physical activity was associated with lower in-hospital (II vs. I: P=0.048, and III vs. I: P=0.01), and cardiac mortality at 39 months (II vs. I: P=0.002, and III vs. I: P<0.001) by univariate analysis, this did not hold true by multivariate analysis.


CONCLUSIONS
In conclusion, the degree of physical activity at the onset of myocardial infarction may be positively associated with acute success of intravenous thrombolysis and this may favorably influence short- and long-term cardiac survival.
Zairis
Michael N
MN
Department of Cardiology, Tzanio Hospital, Zanni and Afentouli Street 1, 18536 Piraeus, Greece. zairis@hellasnet.gt
Psaltiras
George P
GP
Papadaki
Olga A
OA
Psarogianni
Paraskevi K
PK
Lyras
Anastassios G
AG
Giannakopoulos
Andreas K
AK
Andrikopoulos
George K
GK
Adamopoulou
Evdokia N
EN
Olympios
Christopher D
CD
Foussas
Stefanos G
SG
D000328:Adult; D000368:Aged; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006304:Health Status; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000503:physiopathology; D010809:Physical Fitness; D011379:Prognosis; D011446:Prospective Studies; D013300:Streptokinase / Q000627:therapeutic use; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D016896:Treatment Outcome
D005343:Fibrinolytic Agents; D013300:Streptokinase; D010959:Tissue Plasminogen Activator