The Study Of Comparison Of Intravenous Thrombolytic Therapy With Percutaneous Coronary Intervention For Acute Myocardial Infarction

Objective: To investigate the short-time clinical efficacy of intravenous thrombolytic therapy and percutaneous coronary intervention(PCI) by the study of comparison between the two reperfusion methods for acute myocardial infarction(AMI). Methods: Six hundred and twelve patients with AMI in our hospital were studied retrospectively between January 2002 and December 2006. In all patients, one hundred and eight patients were treated by intravenous thrombolytic therapy,two hundred and ninty-three patients were treated by percutaneous coronary intervention. According to inclusion criteria, we select 93 patients who were treated by intravenous thrombolytic therapy and 121 patients who were treated by percutaneous coronary intervention in this study. The clinical feature and relevant parameters(recanalization rate of infarct-related artery, peak amplitude of creatine kinase, left ventricular end diastolic dimesion, left ventricular ejection fraction, major adverse cardiac events, serious bleeding complications, hospitalization days) during hospitalization were compared in two groups. Results: 401 patients accepted reperfusion therapy in all patients, therapeutic ratio of reperfusion is 65.5%. There were no significant differences between the two groups regarding age, gender, accompanying disease, duration from symptom onset to treatment, infarct-related artery(IRA). There were significant differences in recanalization rate of infarct-related artery(66/93,71% VS 117/121,96.7%P<0.05), recurrent myocardial infarction(7/93,7.5% VS 2/121, 1.7%, P<0.05), left ventricular ejection fraction(51.3±7.1% VS 55.3±6.6%,P<0.05), the rate of heart failure(15/93,16.1% VS 8/121,6.6%,P<0.05), hospitalization days (18.2±5.5d VS 12.5±5.0d, P<0.05). There were no significant differences in left ventricular end-diastolic dimesion, major bleeding or mortality(P>0.05). Conclusion: Reperfusion therapy is the most important measure for acute myocardial infarction. Comparing with intravenous thrombolytic therap, percutaneous coronary intervention was more effective in improving cardiac function and decreasing mortality, as well as shortening hospitalization days due to complete and effective reperfusion of IRA after AMI.