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Long-term prognosis of patency of infarct-related coronary artery after thrombolytic treatment in acute myocardial infarction



Long-term prognosis of patency of infarct-related coronary artery after thrombolytic treatment in acute myocardial infarction



Chinese Medical Journal (English Edition) 110(3): 191-194



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 gt 0.1). (2) Three-year survival rates calculated by Kaplan-Meier curve were 91.6% and 73.9% respectively (logrank test, P lt 0.001). (3) Incidence of reinfarction were 5.7% and 5.9% respectively (P lt 0.05). (4) Patients with class III - IV NYHA cardiac function occurred in 11.3% and 17.9% respectively (P lt 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. Conclusion: It is evident that patency of infarct-related coronary artery could improve long-term survival.

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