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EMERGENCY ANGIOPLASTY IS EFFECTIVE IN ACUTE MI.

Although thrombolysis for early acute myocardial infarction has attracted great interest, it is associated with considerable morbidity and is not appropriate for patients with a risk of bleeding complications. The investigators report their experience with emergency angioplasty, an alternative to thrombolysis, in 151 patients.

The procedure was successful in reopening 85 percent of totally occluded arteries and 93 percent of partially occluded arteries. The hospital mortality was 5 percent in patients with successful angioplasty and 37 percent in those with unsuccessful angioplasty; the overall hospital mortality was 9 percent. In cases of successful angioplasty, the ejection fraction increased 10 to 13 percent, depending on the occluded vessel. Mortality after hospitalization was 2 percent during an average follow-up period of 20 months; all three deaths were due to severe congestive heart failure.

Thus, emergency angioplasty appears to salvage the threatened myocardium and is associated with low mortality rates. Whether this technique should be used alone or with thrombolytic agents is unclear.

— THL

Published in Journal Watch General Medicine August 11, 1987

Citation(s):

Rothbaum D A; Linnemeier T J; Landin R J et al. Emergency percutaneous transluminal coronary angioplasty in acute myocardial infarction: a 3 year experience. J Am Coll Cardiol 1987 Aug 10 264-272.

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