COMPARISON OF PATIENTS WITH LESS-THAN-60-PERCENT TO GREATER-THAN-OR-EQUAL-TO-60-PERCENT DIAMETER NARROWING OF THE MYOCARDIAL INFARCT-RELATED ARTERY AFTER THROMBOLYSIS

The purpose of this study was to analyze angiographic findings, clinic al course, and folow-up data on 1,752 patients who underwent protocol cardiac catheterization 18 to 48 hours after enrollment in the Thrombo lysis in Myocardial Infarction (TIMI) II pilot and randomized trial: 2 44 patients (14.0%) had < 60% diameter stenosis in the infarct-related artery and TIMI grade 2 or 3 Row, 1,249 (71.2%) had a narrowing great er than or equal to 60% in diameter with TIMI grade 2 or 3 Row, and 25 9 patients (15%) had TIMI grade 0 or 1 Row (total occlusion). Patients with < 60% narrowing in the infarct-related artery were younger (p < 0.001) and more likely to be current smokers than those with more seve re narrowings (p < 0.003). Patients with < 60% diameter stenosis in th e infarct-related artery were more likely to have a predischarge radio nuclide ejection fraction > 55% (p < 0.001) than were other patient gr oups. The 1-year mortality rate of patients with < 60% diameter stenos is in the infarct-related artery was 1.6% compared with 4.4% for patie nts with stenosis greater than or equal to 60% and TIMI grade 2 or 3 n ow (0 = 0.05) and 7.0% for patients with total occlusion (p = 0.004). Patients with stenosis < 60% in the infarct-related artery 18 to 48 ho urs after thrombolytic therapy have a good prognosis. Infarct artery s tatus predicts predischarge ejection fraction and 1-year mortality.