[Comparison of the clinical efficacy of recombinant tissue-type plasminogen activator thrombolysis with primary coronary stenting in acute myocardial infarction].

OBJECTIVE: To compare the efficacy of low dose recombinant tissue-type plasminogen activator (rt-PA) thrombolysis with primary coronary stenting after acute myocardial infarction (AMI). METHODS: Of 261 patients with first AMI, 131 patients were performed with low dose rt-PA intravenously, and 130 patients with primary coronary stenting. The clinical efficacy of these two groups was compared. RESULTS: The age, time from onset of chest pain to hospital presentation and infarct location between these two groups were comparable. The patency rate of infarct-related artery (IRA) in patients with thrombolysis group was significantly lower than that of patients with primary stenting group (P < 0.00001). The recurrent myocardial infarction, selective coronary stenting of patients with thrombolytic therapy were higher than that of patients with primary stenting group (7.6% vs 1.5%, P < 0.05; 20.6% vs 0, P < 0.001, respectively). The LVEF in patients with thrombolysis group was lower than that of stenting group [(55.6 +/- 13.4)% vs (65.8 +/- 9.2)%, P < 0.0001]. Total hospitalization time of thrombolysis group was longer than that of stenting group [(16 +/- 7) days vs (11 +/- 4) days, P < 0.0001]. The mortality of thrombolysis group was higher than that of stenting group, but this difference was not significant (6.1% vs 3.1%, P > 0.05). CONCLUSIONS: Compared with low dose rt-PA thrombolytic therapy after AMI, primary coronary stenting has a higher patency rate of the IRA, better cardiac function and shorter hospitalization time.