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Updated: May 12, 2026
Primary Outcome Assessment in a Pig Model of Acute Myocardial Infarction
Published on: October 14, 2016
Angiographic estimation of culprit vessel disease severity in acute ST-segment elevation myocardial infarction after
Insights
Successful thrombolysis for ST-elevation myocardial infarction often reveals severe underlying coronary artery disease. Most patients showed significant vessel narrowing, highlighting the need for comprehensive assessment post-treatment.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Medicine
Background:
- Acute ST-elevation myocardial infarction (STEMI) requires prompt reperfusion therapy.
- Thrombolysis is a primary treatment for STEMI, but its effectiveness regarding underlying coronary artery disease severity is crucial.
- Assessing infarct vessel disease severity post-thrombolysis informs prognosis and further management.
Purpose of the Study:
- To evaluate the angiographic disease severity of the infarct vessel in STEMI patients after thrombolysis.
- To determine the 90-day clinical outcomes in these patients.
Main Methods:
- Retrospective analysis of a prospectively maintained cardiology database (February-August 2011).
- Studied 57 STEMI patients who received thrombolysis and subsequent coronary angiography within 24 hours.
- Quantified infarct vessel disease severity (mild, moderate, severe, total occlusion) and assessed 3-month outcomes (recurrent ischemia, revascularization, death).
Main Results:
- Thrombolysis success in 48 patients; 9 failed cases underwent rescue PCI.
- 98.2% of patients exhibited severe (>70%) angiographic disease in the infarct vessel.
- Left anterior descending artery was the most common infarct vessel (56%); 45% had multi-vessel disease.
- One patient experienced recurrent myocardial infarction due to stent thrombosis at 3 months.
Conclusions:
- STEMI patients treated with thrombolysis frequently present with severe underlying coronary artery disease in the infarct vessel.
- Successful thrombolysis does not negate the presence of significant obstructive coronary artery disease.
- Further management strategies should consider the high prevalence of severe disease post-reperfusion.
Introduction:
To study the angiographic disease severity of the infarct vessel after thrombolysis in patients with acute ST-elevation myocardial infarction and their 90 days outcome.
Methods:
We conducted a retrospective analysis of a prospectively maintained cardiology database at Shifa International Hospital from February 2011 to August 2011. A total of 57 patients who underwent thrombolysis for acute ST elevated Myocardial Infarction and subsequent coronary angiographies within 24 hours of hospitalization were studied. Angiographic disease severity in the infarct vessel was quantified as mild (<50%), moderate (50-70%), severe (70-99%) and total occlusion (100%). Secondary outcomes of recurrent ischemia/reinfarction, target lesion revascularization and death were also assessed at three months follow up.
Results:
Thrombolysis was successful in 48 patients. All nine cases of failed thrombolysis underwent rescue PCI. Mean time of catheterization from thrombolysis was 16±4 hours. Total 56 (98.2%) patients had severe (>70%) and 1 patient had moderate (50-70%) angiographic disease of the infarct vessel. Left anterior descending artery was the infarct vessel in 32 (56%) cases and right coronary artery in 20 (35%). Total 15 (26%) patients had double vessel and 11 (19%) had triple vessel coronary artery disease. Percutaneous coronary intervention was performed in all patients using bare metal stents or drug eluting stents. At three month follow-up, only one patient had recurrent myocardial infarction due to stent thrombosis.
Conclusions:
The overwhelming majority of patients presenting with ST elevation myocardial infarction have angiographic evidence of severe underlying disease in the infarct vessel despite clinically successful thrombolysis.
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