The Long-term Clinical Outcomes after Rescue Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction

ABSTRACT

BACKGROUND AND OBJECTIVES: A rescue percutaneous coronary intervention (PCI) has been used to treat the patients after failed thrombolysis in acute myocardial infarction. However, short- and long-term benefits of rescue PCI has not been known exactly. The goal of this study was to examine the clinical and angiographic outcomes, success rate of the procedure, and long-term survival rate after rescue PCI. MATERIALS AND METHODS: Clinical and angiographic outcomes of 31 patients (Group I; 59.7+/-11.4 years, 80.6% male), who underwent rescue PCI were compared with those of 177 patients (Group II; 59.7+/-9.7 years, 79.7% male), primary PCI at Chonnam National University Hospital between January 1997 and December 1999. RESULTS: There were no significant differences in the risk factors for coronary artery diseases except for smoking (Group I; 24/31, 77.4% vs. Group II; 76/177, 42.9%, P<0.05). The incidence of cardiogenic shock was higher in Group I than in Group II (Group I; 7/31, 22.6% vs. Group II; 11/177, 6.2%, P<0.05). The coronary angiographic findings were not different between two groups. Thrombolysis in Myocardial Infarction flow of Group I was lower than in Group II (Group I; 1.14+/-0.93 vs. Group II; 1.61+/-1.14, P<0.05). Primary success rate was 93.6% (29/31) in Group I and 94.9% (168/177) in Group II (P<0.05). Baseline ejection fraction was lower in Group I than in Group II (Group I; 44.2+/-8.9% vs. Group II; 50.8+/-11.7, P<0.05), which improved in both groups (Group I; 51.7+/-7.9% vs. Group II; 60.7+/-13.4%, P<0.05) at six months after the procedures. The survival rate of Group I was 93.5%, 93.5% and 90.3% and that of Group II was 94.5%, 93.7% and 91% at 1 month, 6 and 12 months, respectively. CONCLUSION: Rescue PCI was associated with the risk factor of smoking and the high incidence of cardiogenic shock. The success rate of rescue PCI was comparable with primary PCI and left ventricular function was improved after rescue PCI on long-term clinical follow-up with relatively high survival rate.