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Intern Med ; 45(11): 709-14, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16819250

RESUMO

OBJECTIVE: To examine acute-phase outcomes in acute myocardial infarction (AMI) according to different initial treatments. PATIENTS AND METHODS: This retrospective study involved 405 patients with AMI who had undergone coronary angiography during the acute phase. The patients were retrospectively examined by dividing into groups according to treatment received: intravenous coronary thrombolysis (IVCT) (n=83), intracoronary thrombolysis (ICT) (n=62), and percutaneous coronary intervention (PCI) (n=221). RESULTS: TIMI 3 flow at the initial angiography was higher in the IVCT group (P<0.05) at 32.5% in the IVCT group and 21.7% in the non-IVCT group. The time from onset to initiation of treatment was shorter in the IVCT group (P<0.001) at 227 min in the IVCT group, 337 min in the ICT group, and 479 min in the PCI group. The acute-phase mortality was lower in the IVCT group (P<0.05) at 2.4% in the IVCT group, 3.2% in the ICT group, and 11.8% in the PCI group. According to sub-analysis, the restenosis rate during the chronic phase after PCI did not differ with or without antecedent administration of a thrombolytic agent. CONCLUSION: IVCT as an initial treatment for AMI enabled the fastest reperfusion at TIMI > or = 2 flow, resulting in a good acute-phase outcome.


Assuntos
Angioplastia Coronária com Balão/métodos , Infarto do Miocárdio/tratamento farmacológico , Terapia Trombolítica/métodos , Idoso , Angiografia Coronária , Reestenose Coronária/fisiopatologia , Feminino , Humanos , Infusões Intravenosas , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/fisiopatologia , Reperfusão Miocárdica , Estudos Retrospectivos , Resultado do Tratamento
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