Recombinant tissue plasminogen activator plus rescue coronary interventional procedures and primary coronary interventional procedures in the effective study of acute myocardial infarction

Objective The aim of this study was to compare the effects of primary percutaneous transluminal coronary angioplasty(PTCA)/Stent and thrombolytic agent rt PA 50mg plus rescue PTCA/Stent on the patients with acute myocardial infarction (AMI) Methods 135 patients with first AMI were randomly treated with intravenous rt PA 50mg therapy plus rescue PTCA/Stent (group A ) or with primary PTCA/Stent (group B) 68 of 135 patients received rt PA 50mg after aspirin and heparin Primary PTCA/Stent was in the other 67 patients TIMIflow grade of thrombolysis in myocardial infarction was assessed by angiography (CAG) in emergency and, if recessary, PTCA/Stent was performed The clinical therapeutic effect and the reperfusion rate of IRA, side effects, mortatity and left ventricular function were compared with each other in the two groups Results The reperfusion rate of IRA was 64 7%(29% TIMI2, 35 7 TIMI3) in group A and 33% group B (18% TIMI2, 15% TIMI3) when the patients arrived in the cath labThe IRA of the patients who had become TIMI3 flow was 75%(33/44)in group A and 84 2%(47/57) in group B after PTCA/Stent The left ventricular ejection fraction (LVEF) was calculated by echocardiography before 3 weeks and PTCA/Stent between the two groups The EF of the patients with TIMI3 when arrived in the cath lab(34 patients, 24 in group A , 10 patients in Group B )was 60 8% at first time and 62 5% in second time The EF of patients who had achieved TIMI3 after PTCA/Stent (80 patients ) was 57 0% at first time and 57 2% in second time. The EF of patients who had not achieved TIMI3 (21 patients ) was 54 1% at first time and 53 2% in second time Conclusion Compared with the effect of primary PTCA/Stent, the thrombolytic agent rt PA 50mg plus rescue PTCA/Stent in AMI could also improve the reperfusion of IRA and left ventricular function, which could not increase side effects