Open AccessCoronary angioplasty after intravenous streptokinase in acute myocardial infarction: Influence of restenosis on clinical outcome and left ventricular function
Author(s) -
Leisch F.,
Kerschner K.,
Harringer W.,
Schützenberger W.
Publication year - 1990
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960130405
Subject(s) - medicine , streptokinase , myocardial infarction , angioplasty , cardiology , restenosis , coronary heart disease , ventricular function , stent
The importance of recurrence of stenosis on clinical outcome and left ventricular function was studied in a consecutive series of patients with acute evolving myocardial infarction (maximal duration of pain 4 h) and thrombolysis (1.5 × 10 6 units of streptokinase intravenously over 60 min) with recanalized single‐vessel disease and subsequent successful coronary angioplasty. Coronary angioplasty was performed in 76 patients between 24 hours and 8 days (mean interval 3.3 days) after thrombolysis and was successful in 86s% (65/76). The in‐hospital reinfarction rate was 5.2% (2 acute and 2 in‐hospital reinfarctions). Repeat angiography after a mean interval of 5.9 months revealed a 39% (24/62) restenosis rate (21 restenoses, 3 reocclusions). Restenoses were associated with significantly more clinical complaints (21 % vs. 62%; p < 0.001). Left ventricular function analysis showed significant improvement in the mean global ejection fraction (6.6 ± 6.0%; p < 0.001) and mean regional wall motion of the infarct zone (6.2 ± 8.2%; p < 0.01) only in patients without restenosis. Recovery of left ventricular function was more evident in inferior than in anterior wall infarctions. In contrast, patients with restenosis had no change in left ventricular function. Thus, the present study demonstrates the adverse influence of restenosis on recovery of left ventricular function and clinical outcome.