Comparison of clinical results and life quality after myocardial infarction therapy with primary percutaneous coronary intervention and fibrinolytic angents.

INTRODUCTION

A correct and early diagnosis of ST-segment elevation myocardial infarction (STEMI) and implementation of treatment with the aim to regain patency of the infarct-related artery is crucial for prognosis and the ability to return to normal activities.

OBJECTIVES

The aim of the current analysis was to compare two strategies of STEMI therapy in terms of decreasing the impairment level in patients undergoing treatment, expressed as the time to the return to normal social and professional life.

PATIENTS AND

METHODS

Two 100-patient groups of patients with STEMI were enrolled into the study. In the first group a fibrinolytic drug was used, while in the other primary percutaneous coronary intervention (PPCI) was performed. The material for the study was collected in the unique transitional period (2001-2002), when the 24-hour call schedule in the catheterization laboratories was introduced in the Ludwik Perzyna Complex Hospital in Kalisz.

RESULTS

During the 6-month follow-up mortality in the fibrinolysis group was 18%, and in the PPCI group 1 death (1%). In both groups, there were recurrent chest pain (63% vs. 38.5%, p < 0.0001), the need for nitroglycerin use (73% vs. 37.4%, p < 0.0001), recurrent STEMI (7% vs. 0%, p = 0.02), and recurrent hospitalizations (35% vs. 15.2%, p = 0.003). Marked limitations of activity in family and social life were more commonly observed in the thrombolytic drugs-treated group (p <0.0001). A small percentage of patients who returned to work was observed, however in favor of the PPCI group (20% vs. 38%, p = 0.009). Differences between groups concerning professional status 6 months after STEMI were significant (p = 0.046; chi2).

CONCLUSIONS

Treatment of STEMI with PPCI was associated with an earlier return of respondents to health and a significantly smaller limitation of their activity during the 6-month follow-up.