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Updated: Apr 17, 2026
Myocardial Infarction and Functional Outcome Assessment in Pigs
Published on: April 25, 2014
Prognostic importance of left ventricular function after angioplasty or thrombolysis for acute myocardial infarction
Insights
Primary angioplasty significantly improves long-term survival after myocardial infarction compared to streptokinase therapy. Left ventricular function is a key predictor of mortality in these patients.
Area of Science:
- Cardiology
- Interventional Cardiology
- Clinical Outcomes Research
Background:
- Primary percutaneous coronary intervention (PCI) offers superior short-term outcomes and vessel patency versus thrombolysis for acute myocardial infarction (AMI).
- Limited long-term data existed comparing these reperfusion strategies.
Purpose of the Study:
- To compare the long-term clinical outcomes of primary coronary angioplasty versus thrombolytic therapy in patients with acute myocardial infarction.
- To identify predictors of survival following reperfusion therapy for AMI.
Main Methods:
- A randomized trial involving 395 patients with AMI.
- Patients were assigned to either intravenous streptokinase or primary angioplasty.
- Follow-up extended up to eight years.
Main Results:
- Primary angioplasty demonstrated significantly lower mortality (42 vs. 63 deaths, p=0.03) and a composite of death/nonfatal reinfarction (53 vs. 94 events, p<0.001) compared to streptokinase.
- Sudden death was the primary cause of long-term mortality.
- Multivariate analysis identified left ventricular function as the strongest predictor of overall and sudden death.
Conclusions:
- The long-term benefits of primary angioplasty over streptokinase for acute myocardial infarction are sustained.
- Left ventricular function is a critical determinant of long-term survival post-MI.
Objectives:
To compare long-term clinical outcome after acute myocardial infarction treated with primary coronary angioplasty or thrombolytic therapy, and to study the determinants of survival.
Background:
Primary coronary angioplasty results in a higher patency rate and a better short-term survival when compared with thrombolytic therapy, but so far limited information has been available regarding long-term clinical outcome.
Methods:
Patients with acute myocardial infarction (n=395) were randomised to treatment with either intravenous streptokinase or primary angioplasty, and were followed for up to eight years.
Results:
A total of 105 patients died, 42 patients in the primary coronary angioplasty group compared with 63 patients in the streptokinase group (p=0.03). Death and nonfatal reinfarction occurred in 53 patients in the angioplasty group, compared with 94 patients in the streptokinase group (p<0.001). The major cause of long-term mortality is sudden death. Multivariate analysis showed that left ventricular function was the most important predictor for both total mortality and sudden death.
Conclusion:
The benefits of primary coronary angioplasty compared with streptokinase are well sustained during long-term follow-up.
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