Eventi ischemici successivi a primo infarto miocardico acuto trattato con fibrinolisi. Analisi dei pazienti del GISSI-2 ritenuti ricanalizzati con criterio clinico

Translated title of the contribution: Recurrent ischaemia following first acute myocardial infarction treated with a thrombolytic agent. A GISSI-2 patients analysis considered reperfused with an ECG sign

G. Bardelli, G. Maggi, A. Maggi, S. Barlera

Research output: Contribution to journalArticle

Abstract

Background. The fast normalisation of the ST, after trombolysis, is early sign related to coronary artery reperfusion and to prognosis of acute myocardial infarction (AMI). The aim of this analysis is the evaluation, in the large patients cohort of the GISSI-2 trial, of the relationship between the ST segment evolution after fibrinolytic therapy of AMI and recurrent ischaemic events [angina-reinfarction-ischaemia to exercise testing (ET)] at 30 and 180 days from randomisation. Methods. Patients with first confirmed IMA and ECG before randomisation and 4 hours later, are chosen from GISSI-2 trial. A decrease ≤ 50% of the ΣST elevation is adopted as cutoff for predicting coronary artery patency. Recanalisation is deemed to have occurred in group A patients versus not reperfused group B patients. The studied events are: angina, reinfarction, mortality, at 30 and 180 days from randomisation; ischemia to ET SL of 4-6 week. The results are presented in terms of Mantel-Haenszel odds ratios (OR) and 95% confidence intervals. Results. Group A patients no. 5307 experienced versus group B patients no 2718 a higher incidence of - in-hospital angina: 10.3% vs 7.9% OR 1.30 (1.11-1.52) - 180 days reinfarction: 2.9% vs 1.7% OR 1.66 (1.19-2.30) - Ischaemia to ET 25.4% vs 21.4% OR 1.24 (1.08-1.43), and a lower in-hospital mortality: 3.8% vs 8.5% OR 0.39 (0.32-0.48). Conclusions. Patients having indirect signs of early reperfusion post trombolysis for IMA experience a higher in-hospital and 180 days recurrent ischaemia and a lower mortality; this fact can allow early identification of the patients who can receive a benefit from different therapeutical strategies.

Original languageItalian
Pages (from-to)463-472
Number of pages10
JournalGiornale Italiano di Cardiologia
Volume25
Issue number4
Publication statusPublished - 1995

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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