%0 Journal Article
%T Ultra Early Routine Post-Fibrinolysis Angioplasty Benefits More Patients with Acute ST-Elevation Myocardial Infarction
%A Xianzhi He
%A Xinhong Wan
%A Mingjuan Luo
%A Haiyu Wang
%A Qinghua Zhong
%A Wenjun Peng
%A Jianfang Xue
%J Open Access Library Journal
%V 1
%N 9
%P 1-7
%@ 2333-9721
%D 2014
%I Open Access Library
%R 10.4236/oalib.1101109
%X Objective:
Evaluate whether early routine post-fibrinolysis angioplasty represents a
reasonable reperfusion option for victims of ST-elevation myocardial infarction
(STEMI), so that these patients could benefit more. Methods:
A total of 936 STEMI patients were enrolled in this study to full Urokinase
within 3 hours (h) followed by stenting within 3 - 12
h (Ultra early routine post-fibrinolysis angioplasty; 472 patients), or primary
stenting within 12 h (primary angioplasty; 464 patints). The primary endpoints
were the reperfusion time within 3 h and the incidence of no-reflow or
slow-reflow. The secondary endpoints were the acute incidence of bleeding, the
extent of myocardial damage, determined by the 6-month left ventricular
function and the 3-year composite incidence of death, reinfarction,
stroke, or revascularization. Results: Ultra early routine post-fibrinolysis
angioplasty significantly increased the percentage of reperfusion treatment
within 3 hours (P < 0.01). The primary angioplasty group resulted in higher
frequency of no-reflow or slow-reflow
(P < 0.01).
Both groups were similar regarding major bleeding (P > 0.05). The 6-month
left ventricular function of early routine post-fibrinolysis angioplasty group
was better than primary angioplasty group. Both groups were similar regarding
reinfarction, stroke or revascularization (P > 0.05), but the incidence of
3-year cumulative death is higher in the primary angioplasty group (P < 0.01).
Conclusion: Ultra early routine post-fibrinolysis angioplasty can significantly
improve effective time window within effective reperfusion treatment percentage,
results in better myocardial perfusion, lower
no-reflow and preserving left ventricular function and the prognosis of
patients with STEMI than primary angioplasty.
%K Acute Myocardial Infarction
%K Fibrinolysis
%K Primary Angioplasty
%U http://www.oalib.com/paper/3129827