EFFECTS OF PATENCY OF INFARCT-RELATED CORONARY-ARTERY ON ACUTE OUTCOME IN ACUTE MYOCARDIAL-INFARCTION PATIENTS UNDERGOING UROKINASE THERAPY

Citation
Zj. Chen et al., EFFECTS OF PATENCY OF INFARCT-RELATED CORONARY-ARTERY ON ACUTE OUTCOME IN ACUTE MYOCARDIAL-INFARCTION PATIENTS UNDERGOING UROKINASE THERAPY, Chinese medical journal, 110(3), 1997, pp. 187-190
Citations number
6
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Medicine, General & Internal
Journal title
ISSN journal
0366-6999
Volume
110
Issue
3
Year of publication
1997
Pages
187 - 190
Database
ISI
SICI code
0366-6999(1997)110:3<187:EOPOIC>2.0.ZU;2-J
Abstract
Objective To study the effects of patency of infarct-related coronary artery on acute outcome in cases of acute myocardial infarction underg oing urokinase therapy. Methods One thousand one hundred and thirty-ei ght cases of acute myocardial infarction admitted in 37 collaborative hospitals were given urokinase intravenously with a standard program. Patency of infarct-related coronary artery assessed by uniform criteri a occurred in 757 patients (66.5%) and non-patency in 381 patients (33 .5%). Four-week mortality and frequency of various severe complication s were compared between patency patients and non-patency patients. Res ults The 4-week mortality in patients with patency was 3.4% versus 21. 8% in those without patency (P < 0.001). Frequencies of various severe complications such as heart failure, shock, ventricular fibrillation, bundle branch blocks and mechanical complications (P < 0.01), and com plete atrioventricular block (P < 0.05) were much higher in patients w ithout than in those with patency. In large sized infarcts such as hig h lateral plus anterior wall infarction the difference in 4 week morta lity was even more obvious between patients with and without patency ( 2.6% vs 32.7%, P < 0.001). Using Cox proportional hazards regression m odel analysis, patency of infarct-related coronary artery was defined as the most important independent predictor of 4-week mortality. The r isk ratio for occluded versus parent infarct-related coronary artery w as 6.69. Conclusion On univariate and multivariate analyses, patency o f the infarct-related coronary artery was the most important prognosti c factor for acute outcome in acute myocardial infarction.