[Prognosis of acute myocardial infarction after introduction of thrombolytic therapy]

The present study describes the use of intravenous thrombolytic therapy, the in-hospital and the long-term mortality in a cohort of 1881 consecutive patients with confirmed myocardial infarction. Thirty-two percent received thrombolytic therapy. Common reasons for not administering thrombolytic therapy were contraindications, diagnostic problems and late hospital admission. The total in-hospital mortality was 14% among patients treated with, and 27% among those treated without thrombolytic therapy (p < 0.001). The mortality among all patients after 48 months of follow-up was 50%. Advanced age, previous myocardial infarction and a higher Killip class on admission were independent predictors of an adverse outcome. In conclusion, in an unselected population with confirmed myocardial infarction the long-term prognosis continues to be dubious, despite the advances in coronary care including intravenous thrombolytic therapy.