Direct Ptca With Intravenous Thrombolysis In Acute Myocardial Infarction And Long Term Clinical Efficacy Comparison

In order to compare the clinical efficacy of intravenous thrombolysis with primary percutaneous transluminal coronary angioplasty (PTCA) in acute myocardial infarction (AMI) . Methods 192 patients with first Q wave AMI were individed into two groups； thrombolysis group ( 103 patients were perfomed with intravenous thrombolysis), and PTCA group ( 89 patients underwent primary percutaneous transluminal coronary angioplasty) .The clinical efficacy of these groups was compared. Result The age, time from onset of chest pain to hospital presentation and infarct location between these two groups were comparable. The patency rate of infarct-related artery (IRA) in patients with thrombolysis group was significantly lower than that of patients with primary PTCA group (72.8%vs97.8%, P<0.001). The recurrent myocardial infarction of patients with thrombolytic therapy were higher than that of patients with primary PTCA group (10.7%vs3.4%, P=0.020). The LVEF in patients with thrombolysis group was lower than that of PTCA group [(56.75±10.82)%vs(65.42±9.38)%, P<0.001]. Total hospitalization time of thrombolysis group was longer than that of PTCA group [(16.15±4.42) days vs (10.79±3.23) days , P<0.001]. The mortality of thrombolysis group was higher than that of PTCA group , but these difference was in significant (5.8% vs 3.3%, P=0.422). One year later, 12 cases were lose in thrombolysis group and 8 in PTCA group. The LVEF was higher inPTCA group than thrombolysis group[(60.63±6.59)%vs(52.52±7.25%,P<0.001). The mortality of thrombolysis group was higher than that of PTCA group, but this difference was in significant (12.1%vs8.6%, P=0.461). The cases with post-infarction angina, myocardial re-infarction and repeat revascularization were less in PTCA group (P<0.05, respectively). Conclusion Compared with the primary PTCA and intravenous thrombolytic therapy in the treatment of AMI, primary PTCA increased patency rate of the IRA, improved cardiac function and survival ,decreased hospitalization time and mortality.