May 29, 2026Open Access
Preservation of global and regional left ventricular function after early thrombolysis in acute myocardial infarction
Key Result
Early thrombolytic therapy significantly preserved left ventricular ejection fraction compared with conventional treatment (53% vs 47%) in patients with acute myocardial infarction.
Key Points
- The research aims to determine the effects of early thrombolysis on left ventricular function in acute myocardial infarction.
- Conducted a randomized trial comparing early thrombolysis with standard care.
- Evaluated global and regional left ventricular function through echocardiography.
- Included patients presenting with acute myocardial infarction.
- Early thrombolysis showed significant preservation of global left ventricular function compared to standard care (effect size not provided).
- Regional left ventricular function was better maintained in the thrombolysis group (specific metrics not provided).
Study Design
Type
RCT (n=533)
Structured PICO
Does early thrombolytic therapy improve global and regional left ventricular function in patients with acute myocardial infarction?
P
Population
533 patients with acute myocardial infarction (within 4 hours after onset of symptoms)
I
Intervention
Early myocardial reperfusion (thrombolytic therapy) within 4 hours after onset of symptoms
C
Comparator
Conventional coronary care unit therapy
O
Outcome
Global and regional left ventricular function (ejection fraction and segmental wall motion) assessed by angiogram at 2 to 8 weekssurrogate
Early thrombolysis within 4 hours of acute myocardial infarction significantly preserves global and regional left ventricular function compared to conventional therapy.
Main Result
Absolute Event Rate: 53% vs 47%
Abstract
The effect of early myocardial reperfusion (within 4 hours after onset of symptoms) on regional left ventricular function in patients with acute myocardial infarction has been quantitated by analysis of segmental wall motion. Of 533 patients randomized either to conventional coronary care unit therapy or to a reperfusion strategy, in 332 high quality angiograms were obtained 2 to 8 weeks after the onset of myocardial infarction. In those assigned to thrombolytic therapy, angiographic data were also available after acute reperfusion. Analysis on an "intention to treat" basis revealed significant preservation of left ventricular function after thrombolytic therapy (ejection fraction 53%) compared with conventional treatment (ejection fraction 47%). In addition, wall motion analysis showed significant improvement of regional function in the infarct zone in both inferior and anterior infarction. In addition, significant changes occurred in regional function of the remote "noninfarct zone" in the acute as well as the chronic stage. It is concluded that improved regional and global left ventricular function can be achieved with early reperfusion and that this is the likely explanation for the reduction of early and late mortality after thrombolysis observed in this study.