ARE THERE DIFFERENCES IN LATE OUTCOME AFTER PTCA FOR ANGINA-PECTORIS AFTER NON-Q-WAVE VS Q-WAVE MYOCARDIAL-INFARCTION

Aims Revascularization is thought to improve prognosis better if ischa emia persists after so-called non-Q wave myocardial infarction, than a fter Q-wave myocardial infarction, because if is assumed that prognosi s is better where there is less left ventricular function loss. This s tudy evaluates the differences in clinical outcome between patients wi th Q wave and those with non-Q wave myocardial infarction who underwen t percutaneous transluminal coronary angioplasty because of recurrent ischaemia. Methods We retrospectively analysed two consecutive groups of patients who underwent percutaneous transluminal coronary angioplas ty for ischaemia after either a non-Q wave (n=175) or a Q wave (n=175) myocardial infarction, and who were followed for 4 years. Results Ini tial angioplasty success rates were similar in both groups. At follow- up there were no significant differences between the two patient group s in rates of death (9% vs 11%, P=ns), myocardial infarction (3% vs 7% , P=ns) and target vessel revascularization by repeat percutaneous ang ioplasty (11% vs 15%, P=ns) or coronary bypass surgery (both 7%). Conc lusion We conclude that elective coronary angioplasty in patients with angina pectoris after non-Q wave myocardial infarction does not lead to a better prognosis than after Q wave myocardial infarction. Thus, m anagement strategies after myocardial infarction should not be based o n the absence or presence of Q waves on the electrocardiogram.