The Role of Intravenous Coronary Thrombolysis for Patients with Acute Myocardial Infarction in Different Treatment Strategies

Kobayashi Hiroshi, Takazawa Kenji, Matsumoto Chisa, Ooi Kuniomi, Nagata Takuya, Katou Kouta, Yoshida Masanobu, Aiga Mamoru, Aizawa Akira, Takahashi Eiji, Namatame Yasuhide, Kinou Mineko, Yamashina Akira

doi:10.2169/internalmedicine.45.1576

Objective: To examine acute-phase outcomes in acute myocardial infarction (AMI) according to different initial treatments.<br> 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).<br> 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.<br> Conclusion: IVCT as an initial treatment for AMI enabled the fastest reperfusion at TIMI ≥2 flow, resulting in a good acute-phase outcome.<br>

The Role of Intravenous Coronary Thrombolysis for Patients with Acute Myocardial Infarction in Different Treatment Strategies

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