The study on the clinical effects and short-term results of time-limited rescue angioplasty following thrombolytic therapy in acute myocardial infarction

Objective To evaluate the rationality, safety and efficiency of the time-limited rescue angioplasty following thrombolytic therapy in acute myocardial infarction (AMI).Methods Among the patients within 6 hours from the onset of symptoms of AMI, forty-four cases (group A) underwent primary coronary angioplasty and fifty-eight cases (group B) underwent firstly intravenous thrombolytic therapy. According to clinical early reperfusion indication within 90 minutes following thrombolytic therapy, group B was divided into two subgroups, the patients with early reperfusion (subgroup C) underwent delayed interventional examination 7～10 days after AMI and that with non-reperfusion (subgroup D) underwent rescue angioplasty. The reperfusion rates and complications in different groups were analyzed and compared. Cardiac function (left ventricular ejection fraction, LVEF) was evaluated by echocardiograph 4 weeks after AMI. Results The results showed that the rate of reperfusion, in group A, was 95.45% (42/44),that of subgroup C was 32.76 % (19/58) within 90 minutes following thrombolytic therapy (16 of subgroup C underwent delayed interventional examination and 12 of them underwent PTCA+stent) and that of subgroup D was 97.43% (38/39); There were no serious complications that occurred in subgroups C and D. The LVEFs in group A, subgroups C and D were not significantly different, but there was a significant difference between reperfusion within 6 hours and beyond after AMI (62.7% vs 56.8%, P0.05) reperfusion method in AMI.Conclusion The time-limited rescue angioplasty following thrombolytic therapy is a rational, safety and efficient.