Can Recanalization Therapy Reduce the Early Mortality of Patients with Acute Myocardial Infarction? : Seven Years Experience in our Hospital

During the past 7 years (1984～1990) 391 patients with acute myocardial infarction (MI) admitted to our hospital. These patients were divided into the following 3 groups by the therapy which performed within 24 hours of the onset of MI. (1) Conservative therapy group： 239 patients who received neither ICT nor PTCA； 66±11y.o., M/F=2.2 (2) ICT group： 81 patients who received intracoronary thrombolysis (ICT) without rescue PTCA； 61±10y.o., M/F=4.1 (3) PTCA group： 71 patients who received PTCA (56 patients as rescue PTCA after unsuccessful ICT, 15 patients as direct PTCA)； 63±10y.o., M/F=7.9 In patients received ICT, PTCA and conservative therapy, hospital mortality at 4 weeks after the admission was 7.4%, 5.6% and 20.9% respectively. During these admission additional intervention (ICT, PTCA or CABG) were performed in 18 patients (22.2%) of ICT group, 5 patients (7.0%) of PTCA group and in 25 patients (10.5%) of the group who treated conservatively. Therefore, recanalization therapy (both ICT and PTCA) for acute MI appeared to reduce the early mortality (p<0.01). And also PTCA reduce the necessity of the additional intervention as compared with ICT (p