LONG-TERM EFFECTS ON LEFT-VENTRICULAR FUNCTION AFTER LATE THROMBOLYSIS IN PATIENTS WITH MYOCARDIAL-INFARCTION

This open-label, uncontrolled, retrospective study assessed the long-t erm effects of late thrombolysis on left ventricular (LV) function, We studied 79 patients (52 men and 27 women; mean age, 51 +/- 5 years) t reated with alteplase (group 1) and 46 patients (33 men and 13 women; mean age, 52 +/- 8 years) treated with heparin alone (group 2) at thei r first myocardial infarction (MI). Patients were eligible for the stu dy if they were younger than 62 years, their duration of pain was long er than 6 hours, and they had no episodes of angina in the 48 hours pr eceding their MI. The peak of creatine kinase-muscle and brain subunit s was significantly less in group 1 than group 2 (106 +/- 67 vs 205 +/ - 102 IU/L). Both LV ejection fraction and call-motion score were bett er in thrombolysed patients, and the cumulative frequency of radionucl ide defects was higher in these patients during the 4-year follow-np. Our study supports the concept that thrombolysis reduces the incidence of long-term post-Mi residual ischemia, improving global LV function even when given late after the onset of MI symptoms.