+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Long-term prognosis of patients undergoing thrombolysis during the acute phase of myocardial infarction



Long-term prognosis of patients undergoing thrombolysis during the acute phase of myocardial infarction



Annales de Cardiologie et d'Angeiologie 46(5-6): 303-310



Objective: The objective of this study was to analyse the long-term mortality and morbidity of a group of patients undergoing thrombolysis during the acute phase of myocardial infarction and to determine the factors influencing the prognosis. One hundred and seventy five patients (149 mean and 26 women, mean age: 54 years) were included in a randomized study, comparing the efficacy of 2 thrombolytic substances administered during the acute phase of myocardial infarction. A standard questionnaire was sent to the various attending physicians for follow-up of these 175 patients. Results: the hospital mortality was 5% (9 patients) and 14 patients (9%) died after a mean follow-up of 4.3 +- 2.1 years. The 5-year actuarial survival was 81%. Fourteen patients (8%) were lost to follow-up and 49 patients (32%) underwent surgical or percutaneous revascularization during follow-up. Revascularized patients had a significantly better survival than non-revascularized patients. The mean left ventricular ejection fraction of patients who died was lower (48% versus 71%) than that of survivors. Patients with an ejection fraction lt 40 % also had a significantly lower survival (p = 0.01). Patency of the vessel after thrombolysis was associated with a slightly better survival; this difference was not significant. The ejection fraction at 6 month was also significantly higher (60 +- 10% versus 49 +- 11%) for patients with a patent artery. Three risk factors for death or reinfarction were identified: age gt 65 years at the time of infarction, disease in more than one coronary vessel and absence of angina pectoris before infarction. The probability of a coronary accident varied from 2 to 86% according to the number of risk factors present. At the time of follow-up, 60% of patients presented hypercholesterolemia versus only 7% before infarction. 73% of patients received anticoagulant or antiaggregant treatment and 81% of patients were asymptomatic. Conclusion: The mortality and the acute and long-term morbidity of myocardial infarction remain high, as only 34% of our patients did not develop any events during follow-up, despite serious medical management and follow-up. The ejection fraction has an important prognostic value. Patient management should take the above-mentioned risk factors into account.

Please choose payment method:






(PDF emailed within 1 workday: $29.90)

Accession: 008971806

Download citation: RISBibTeXText

PMID: 9295890


Related references

Long-term prognosis of patients with acute myocardial infarction in the thrombolysis era. European Heart Journal 16(ABSTR Suppl. ): 374, 1995

Short- and long-term effects of early fosinopril administration in patients with acute anterior myocardial infarction undergoing intravenous thrombolysis: Results from the Fosinopril in Acute Myocardial Infarction Study. American Heart Journal 136(2): 213-225, 1998

The long term prognosis in patients following thrombolysis of acute myocardial infarction: A view from a community hospital. International Journal of Cardiology 55(3): 277-283, 1996

Relationship between thrombolysis in myocardial infarction risk index and the severity of coronary artery lesions and long-term outcome in acute myocardial infarction patients undergoing percutaneous coronary intervention. Zhonghua Xin Xue Guan Bing Za Zhi 46(11): 874-881, 2018

Distortion of the terminal portion of the QRS on the admission electrocardiogram in acute myocardial infarction and correlation with infarct size and long-term prognosis (thrombolysis in myocardial infarction 4 trial). American Journal of Cardiology 78(4): 396-403, 1996

Long-term prognosis of patients with acute non-ST-segment elevation myocardial infarction undergoing different treatment strategies. Chinese Medical Journal 128(8): 1026-1031, 2015

Short and long term prognosis of acute myocardial infarction since introduction of thrombolysis. BMJ 307(6900): 349-353, 1993

Effect of coronary collaterals on long-term prognosis in patients undergoing primary angioplasty for acute ST-elevation myocardial infarction. American Journal of Cardiology 106(5): 605-611, 2010

Long-term prognosis of late spontaneous reperfusion after failed thrombolysis for acute myocardial infarction. Clinical Cardiology 22(12): 787-790, 1999

Patients with acute myocardial infarction and severe target lesion calcifications undergoing percutaneous coronary intervention have poor long-term prognosis. Kardiologia Polska 75(9): 859-867, 2017

The use of tissue type plasminogen activator for acute myocardial infarction in the elderly results from thrombolysis in myocardial infarction phase i open label studies and the thrombolysis in myocardial infarction phase ii pilot study. Journal of the American College of Cardiology 14(5): 1159-1165, 1989

Long-Term clinical outcomes according to initial management and thrombolysis in myocardial infarction risk score in patients with acute non-ST-segment elevation myocardial infarction. Yonsei Medical Journal 51(1): 58-68, 2010

Long-term prognosis of patients with acute myocardial infarction in the era of acute revascularization (from the Heart Institute of Japan Acute Myocardial Infarction [HIJAMI] registry). International Journal of Cardiology 159(3): 205-210, 2013

Long-term prognosis following myocardial infarction in younger versus older patients in the thrombolysis era. Wiener Klinische Wochenschrift 109(Suppl. 1): 63, 1997

Effects of hemoglobin levels on long-term prognosis in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Zhonghua Yi Xue Za Zhi 91(42): 3003-3006, 2011