Survival Benefit of the Late Percutaneous Coronary Intervention in the Patients after Acute Myocardial Infarction Who Are Or Who Are Not Treated with Thrombolysis

  • Božidarka Knežević Clinical Center of Montenegro, Center of Cardiology
  • Nebojša Bulatović Clinical Center of Montenegro, Center of Cardiology
  • Nataša Belada Clinical Center of Montenegro, Center of Cardiology
  • Vesna Ivanović Clinical Center of Montenegro, Center of Cardiology
  • Siniša Dragnić Clinical Center of Montenegro, Center of Cardiology
  • Miroslav Rabrenović Clinical Center of Montenegro, Center of Cardiology
  • Goran Nikolić Clinical Center of Montenegro, Center of Cardiology
  • Ljilja Musić Clinical Center of Montenegro, Center of Cardiology
  • Aneta Bošković Clinical Center of Montenegro, Center of Cardiology
Keywords: Thrombolysis, prognosis

Abstract

The impact of late percutaneous coronary intervention (PCI) in the patients after acute myocardial infarction (AMI) on long term mortality remains to be established. At currently, thrombolysis is accepted as standard therapy when PCI is not immediately available. However, PCI is often performed in stable patients with AMI who are/are not received thrombolysis .
We performed the trial that enrolled myocardial infarction patients treated with thrombolysis, late PCI and medically to assess the potential benefits of delayed PCI.
We follow up 164 consecutive patients after AMI one year. The patients are divided in two groups; first group-66 patients who received reperfusion (37 patients received only thrombolysis, 10 patients received thrombolysis and PCI 7-9 days after thrombolysis and 19 patients underwent only PCI after 7-9 days) and second group-98 patients medically treated. One year mortality was 3% in the reperfusion group (2/66) and 14,3% in the medical group (14/98) (p=0,016). There were not significant differences between groups about other end points-reinfarctus, coronary artery bypass surgery and PCI performed later after discharge. The major predictors of one year mortality were ages (p<0,001) and ejection fraction (p=0,003). Also, therapy with beta-blockers (p=0,002), statins (p=0,001) and ACE-inhibitors (p=0,024) was associated with better survival.
Delayed PCI performed 7-9 days after AMI in the patients who underwent thrombolysis or those did not improves outcome at long-term follow-up

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Published
2009-02-20
How to Cite
1.
Knežević B, Bulatović N, Belada N, Ivanović V, Dragnić S, Rabrenović M, Nikolić G, Musić L, Bošković A. Survival Benefit of the Late Percutaneous Coronary Intervention in the Patients after Acute Myocardial Infarction Who Are Or Who Are Not Treated with Thrombolysis. Bosn J of Basic Med Sci [Internet]. 2009Feb.20 [cited 2019Sep.18];9(1):54-8. Available from: http://www.bjbms.org/ojs/index.php/bjbms/article/view/2857
Section
Translational and Clinical Research