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Direct PTCA with intravenous thrombolysis for acute myocardial infarction and long term clinical efficacy comparison

Author: JinJiYong
Tutor: CuiLan
School: Yanbian University
Course: Internal Medicine
Keywords: Acute myocardial infarction Percutaneous transluminal coronary angioplasty Intravenous thrombolysis Prognosis
CLC: R542.22
Type: Master's thesis
Year: 2003
Downloads: 43
Quote: 0
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Abstract


In order to investigate the direct percutaneous transluminal coronary angioplasty (PTCA) with thrombolytic therapy for acute myocardial infarction (AMI) and long term clinical efficacy, this study selected 192 cases of first AMI patients, 103 patients received thrombolytic therapy (thrombolysis group), 89 patients received the infarct-related artery (IRA) percutaneous transluminal coronary angioplasty (PTCA group) were compared between patients with clinical treatment. Cardiac events within one year of follow-up situation. The results show that thrombolysis recanalization rate was 72.8% (75/103), PTCA group recanalization rate was 97.8% (87/89), the difference was significant (P lt; 0.001); thrombolysis group re- of myocardial infarction was significantly higher than PTCA group (10.7% vs 2.2%, P = 0.020); thrombolysis group left ventricular ejection fraction was significantly lower than during hospitalization PTCA group [(56.75 ± 10.82)% and (65.42 ± 9.38)%, P lt; 0.001]; thrombolysis group hospital mortality than PTCA group, but no significant difference (respectively 5.8% and 3.3%, P = 0.422); thrombolysis group effort after infarction during hospitalization failure rate was 11.7% (12), PTCA group was 3.4% (3), thrombolysis group than PTCA group, and there was significant difference (P = 0.033); thrombolysis group of bleeding complications than PTCA group (9.7 % vs 2.2%, P = 0.033), there are significant differences; remedy PTCA number of cases during hospitalization thrombolysis group than PTCA group (12.6% vs 0%, P = 0.001), the number of cases of elective PTCA PTCA than thrombolysis group group (22.3% vs 0%, P lt; 0.001), two showed significant differences; thrombolysis group was significantly greater than the number of days in hospital PTCA group (16.15 ± 4.42 and 10.79 ± 3.23, P lt; 0.001). A year later, thrombolysis group lost 12 cases, PTCA group lost eight cases. Between two groups, the incidence of recurrent angina thrombolysis group was 19.8% (18/91), PTCA group was 8.6% (7/81), a significant difference (P lt; 0.05); LVEF is [(52.52 ± 7.25) = 0.461), but no significant difference; reinfarction, revascularization again, the number of cases, the number of cases of recurrent angina, PTCA group were lower than other thrombolytic group, and there was significant difference (P lt; 0.05). Results from this study showed that: compared with intravenous thrombolysis, direct PTCA can significantly increase the IRA recanalization rate, better protect cardiac function, reduce hospitalization time and improve the prognosis and improve survival.

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CLC: > Medicine, health > Internal Medicine > Heart, blood vessels ( circulatory ) disease > Heart disease > Myocardial diseases > Myocardial infarction
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