The Role of Intravenous Coronary Thrombolysis for Patients with Acute Myocardial Infarction in Different Treatment Strategies

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Author(s)

    • Takahashi Eiji
    • Department of Cardiology, Tokyo Medical University Hachioji Medical Center
    • Kinou Mineko
    • Department of Cardiology, Tokyo Medical University Hachioji Medical Center
    • Takazawa Kenji
    • Department of Cardiology, Tokyo Medical University Hachioji Medical Center
    • Matsumoto Chisa
    • Department of Cardiology, Tokyo Medical University Hachioji Medical Center
    • Ooi Kuniomi
    • Department of Cardiology, Tokyo Medical University Hachioji Medical Center
    • Nagata Takuya
    • Department of Cardiology, Tokyo Medical University Hachioji Medical Center
    • Katou Kouta
    • Department of Cardiology, Tokyo Medical University Hachioji Medical Center
    • Yoshida Masanobu
    • Department of Cardiology, Tokyo Medical University Hachioji Medical Center
    • Aiga Mamoru
    • Department of Cardiology, Tokyo Medical University Hachioji Medical Center
    • Aizawa Akira
    • Department of Cardiology, Tokyo Medical University Hachioji Medical Center

Abstract

<b>Objective:</b> To examine acute-phase outcomes in acute myocardial infarction (AMI) according to different initial treatments.<br> <b>Patients and Methods:</b> This retrospective study involved 405 patients with AMI who had undergone coronary angiography during the acute phase. The patients were retrospectively examined by dividing into groups according to treatment received: intravenous coronary thrombolysis (IVCT) (n=83), intracoronary thrombolysis (ICT) (n=62), and percutaneous coronary intervention (PCI) (n=221).<br> <b>Results:</b> TIMI 3 flow at the initial angiography was higher in the IVCT group (P<0.05) at 32.5% in the IVCT group and 21.7% in the non-IVCT group. The time from onset to initiation of treatment was shorter in the IVCT group (P<0.001) at 227 min in the IVCT group, 337 min in the ICT group, and 479 min in the PCI group. The acute-phase mortality was lower in the IVCT group (P<0.05) at 2.4% in the IVCT group, 3.2% in the ICT group, and 11.8% in the PCI group. According to sub-analysis, the restenosis rate during the chronic phase after PCI did not differ with or without antecedent administration of a thrombolytic agent.<br> <b>Conclusion:</b> IVCT as an initial treatment for AMI enabled the fastest reperfusion at TIMI ≥2 flow, resulting in a good acute-phase outcome.<br>

Journal

  • Internal Medicine

    Internal Medicine 45(11), 709-714, 2006

    The Japanese Society of Internal Medicine

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