LONG-TERM PROGNOSIS AFTER THROMBOLYTIC THERAPY FOR ACUTE MYOCARDIAL-INFARCTION

In order to clarify the relationship between the patency of the infarc ted arteries and subsequent long-term prognosis after thrombolytic the rapy, we evaluated 116 patients with acute myocardial infarction treat ed with intracoronary (112 patients) or intravenous (four patients) ur okinase. Patients treated with angioplasty after thrombolysis were exc luded. The infarcted vessel was recanalized in 52 patients (patent gro up) and was not in the remaining 64 patients (occluded group). Five-ye ar and 8-year follow up was conducted in 91% and 81% of the patients, respectively. The 1-, 5- and 8-year survival rate for the patent and o ccluded group was 91.8 and 80.9%, 80.8 and 79.2%, and 75.9 and 75.6%, respectively. The survival rate in the patent group tended to be highe r than that in the occluded group up to 4 years. However, after 5 year s, both groups showed similar survival rates. Therefore, reopening of the infarcted arteries with thrombolysis was not an independent predic tor for late cardiac death (Cox regression analysis).