Why the study?
Does thrombolysis reduce long-term mortality in patients aged ≤ 65 years who survived a first acute myocardial infarction?
Does thrombolysis reduce long-term mortality in patients aged ≤ 65 years who survived a first acute myocardial infarction?
Thrombolysis provides a progressive long-term prognostic benefit in patients aged ≤ 65 years surviving a first acute myocardial infarction.
Thrombolysis was associated with lower 4- to 5-year mortality; hypothesis-generating and should not yet change practice in first-MI survivors.
This community nonrandomized study comprised a consecutive cohort of 1,545 (81% males) < or = 65-year-old patients who survived a first acute myocardial infarction (AMI). The all-cause 4- to 5-year mortality rate was 9% (80% cardiac). Univariate analysis revealed that older age, female gender, hypertension, diabetes, not undergoing thrombolysis, higher Killip class, preinfarction heart disease, peripheral vascular disease (PVD) and chronic obstructive lung disease (COLD) were significantly associated with increased mortality. Multivariate analyses disclosed the latter five parameters as being independent predictors of mortality. Our results show that patients undergoing thrombolysis enjoyed a progressive prognostic benefit over time. The independent contribution of PVD and COLD to long-term mortality is highlighted, in addition to the contribution of thrombolytic therapy, Killip class, and heart disease prior to infarction as being important predictors of long-term mortality in patients with a first AMI.
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Shapira et al. (2000) studied this question.
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