Combined thrombolytic therapy and PTCA resulted in a greater improvement in regional wall motion compared to thrombolytic therapy alone (0.8 ± 1.2 vs 0.2 ± 0.9 SD/chord, p<0.05).
Observational (n=129)
Does thrombolytic therapy and/or immediate coronary angioplasty improve left ventricular function in patients with acute transmural myocardial infarction?
Residual stenosis, time to treatment, and initial global impairment are major predictors of left ventricular functional recovery after reperfusion therapy for acute myocardial infarction.
To determine the effect of thrombolytic therapy and/or immediate coronary angioplasty (PTCA) on left ventricular function, 129 patients with acute transmural myocardial infarction were retrospectively studied. Treatment strategies included thrombolytic therapy alone (n = 29), PTCA alone (n = 41), and combined thrombolytic therapy and PTCA (n = 59). Left ventricular ejection fraction (LVEF) and infarct zone regional wall motion (RWM) were determined from contrast ventriculography obtained acutely and at day 7–10. In the overall group, there was a 2 ± 9% increase in LVEF (p 40% demonstrated a more significant ΔLVEF than patients; ± 40% (7 ± 8vs 1 ± 8%, p < 0.007). A significant improvement in ΔLVEF was noted only in patients with an anterior infarction when compared to patients with an inferior infarction. Age, sex, presence of multivessel disease, history of prior myocardial infarction, initial patency of the infarct vessel, and presence of collaterals had no effect on left ventricular function. Stepwise multiple regression identified residual stenosis, time to treatment, and the degree of initial global impairment as the major joint predictors of ventricular functional recovery. (J Interven Cardiol 1988:1:3)
Langburd et al. (1988) conducted an observational in acute transmural myocardial infarction (n=129). Thrombolytic therapy and/or immediate coronary angioplasty (PTCA) vs. Thrombolytic therapy alone, PTCA alone, or combined therapy was evaluated on Change in left ventricular ejection fraction (LVEF) and infarct zone regional wall motion (RWM) between day 1 and day 7-10. Combined thrombolytic therapy and PTCA resulted in a greater improvement in regional wall motion compared to thrombolytic therapy alone (0.8 ± 1.2 vs 0.2 ± 0.9 SD/chord, p<0.05).