Author(s)

Xianzhi He¹, Xinhong Wan^2*, Mingjuan Luo³, Haiyu Wang⁴, Qinghua Zhong⁴, Wenjun Peng⁴, Jianfang Xue⁴

¹Department of Cardiology, The Second People’s Hospital of Zhuhai, Zhuhai, China.
²Department of Cardiology, Longgang District People’s Hospital of Shenzhen, Shenzhen, China.
³The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
⁴Department of Cardiology, Longgang District Central Hospital of Shenzhen, Shenzhen, China.

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.

Acute Myocardial Infarction, Fibrinolysis, Primary Angioplasty

He, X. , Wan, X. , Luo, M. , Wang, H. , Zhong, Q. , Peng, W. and Xue, J. (2014) Ultra Early Routine Post-Fibrinolysis Angioplasty Benefits More Patients with Acute ST-Elevation Myocardial Infarction. Open Access Library Journal, 1, 1-7. doi: 10.4236/oalib.1101109.