1. Long-term beneficial effect of late reperfusion for acute anterior myocardial infarction with percutaneous transluminal coronary angioplasty
- Author
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Kazuo Minai, Masafumi Izumi, Masayuki Takahashi, Hajime Horie, Hiroshi Yokohama, Tamotsu Fujita, Taizo Sakamoto, Masahiko Kinoshita, Atsushi Takaoka, Masato Nozawa, Hiroshi Okamura, and Osamu Kito
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Myocardial Infarction ,Coronary Disease ,Myocardial Reperfusion ,Revascularization ,Coronary Angiography ,Ventricular Function, Left ,Physiology (medical) ,Angioplasty ,Internal medicine ,medicine ,Humans ,cardiovascular diseases ,Myocardial infarction ,Angioplasty, Balloon, Coronary ,Aged ,Proportional Hazards Models ,Ejection fraction ,business.industry ,Hazard ratio ,Electrocardiography in myocardial infarction ,Middle Aged ,medicine.disease ,medicine.anatomical_structure ,Treatment Outcome ,Heart failure ,Acute Disease ,cardiovascular system ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Artery ,Follow-Up Studies - Abstract
Background —Although the short-term and long-term beneficial effects of early coronary revascularization by primary PTCA or thrombolytic therapy have been established for acute myocardial infarction, thrombolytic therapy >24 hours after the onset of acute myocardial infarction has not been shown to improve clinical outcome. The purpose of this study was to assess the effect of late revascularization by primary PTCA over a 5-year period. Methods and Results —Eighty-three patients with initial Q-wave anterior myocardial infarction >24 hours after onset were randomized into a PTCA group (n=44) and a no-PTCA group (n=39). Long-term follow-up was conducted with regard to end points, which included cardiac death, nonfatal recurrence of myocardial infarction, and development of congestive heart failure. Left ventricular ejection fraction and regional wall motion at 6 months after myocardial infarction were similar in the 2 groups. Left ventricular end-diastolic and end-systolic volume indexes were significantly smaller in the PTCA group than in the no-PTCA group ( P P Conclusions —In initial Q-wave anterior myocardial infarction, we conclude that even with late reperfusion, PTCA had beneficial effects on cardiac events over the 5-year period after myocardial infarction, with the prevention of left ventricular dilation after myocardial infarction being a possible mechanism.
- Published
- 1998