The importance of patency of the infarct-related artery in treatment of patients with acute myocardial infarction.

N Ernst, F Zijlstra, M J de Boer, J H E Dambrink, A T M Gosselink, J P S Henriques, A W J van 't Hof, J C A Hoorntje, J C C van der Horst, H Suryapranata

Netherlands Heart Journal · 2003-01-01 · Observational study

PubMed

Abstract

OBJECTIVE: To study the impact of patency of the infarct-related artery on the coronary angiogram, both before and after primary angioplasty for acute myocardial infarction, on 30-day mortality. METHOD: Data of 1702 consecutive patients treated with primary angioplasty for acute myocardial infarction were collected prospectively from 1994 to 2000. RESULTS: Patients with a (partially) patent infarct artery before primary angioplasty had less damage to the myocardium and a lower 30-day mortality (1.6% versus 3.4%, p=0.04) compared with patients with an occluded artery. Patients with pre-hospital treatment with aspirin and heparin more often presented with a patent artery before angioplasty (31% versus 20%, p<0.001). After primary angioplasty, 95% of patients had a patent artery with a 30-day mortality of 2.2%. The 5% of patients with failed angioplasty had extensive myocardial damage and a 30-day mortality rate of 17%. CONCLUSION: Patency of the infarct-related artery on the coronary angiogram, both before and after primary angioplasty, has a major impact on 30-day mortality.

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Antithrombotics & thrombolytics · Acetylsalicylic acid · Heparin · Mortality & survival