BACKGROUND: Few studies have examined the long-term outcome of primary PTCA for acute myocardial infarction, especially in thrombolysis-eligible patients. METHODS: Retrospective analysis of a consecutive cohort of 228 patients treated with primary angioplasty for ST-segment elevation myocardial infarction, less than 6 h after symptom onset, of whom 203 were discharged alive and had long-term follow-up. RESULTS: With an average follow-up of 497+/-40 days, actuarial survival rates were 94.4+/-0.02 and 86.8+/-0.06% at 2 and 4 years, respectively. Multivariate analysis showed that lack of beta-blocker therapy at discharge (RR 6.5 and 95% CI: 1.97-21.47) and age (RR 1.09 per year and 95% CI: 1.03-1.16), but not left ventricular ejection fraction were the two independent predictors of late mortality. CONCLUSIONS: In thrombolysis-eligible patients treated with primary PCI and discharged alive, reinfarction and mortality rates are low. It appears particularly important to enforce prescription of beta-blockers at discharge is an important goal in this population.
BACKGROUND: Few studies have examined the long-term outcome of primary PTCA for acute myocardial infarction, especially in thrombolysis-eligible patients. METHODS: Retrospective analysis of a consecutive cohort of 228 patients treated with primary angioplasty for ST-segment elevation myocardial infarction, less than 6 h after symptom onset, of whom 203 were discharged alive and had long-term follow-up. RESULTS: With an average follow-up of 497+/-40 days, actuarial survival rates were 94.4+/-0.02 and 86.8+/-0.06% at 2 and 4 years, respectively. Multivariate analysis showed that lack of beta-blocker therapy at discharge (RR 6.5 and 95% CI: 1.97-21.47) and age (RR 1.09 per year and 95% CI: 1.03-1.16), but not left ventricular ejection fraction were the two independent predictors of late mortality. CONCLUSIONS: In thrombolysis-eligible patients treated with primary PCI and discharged alive, reinfarction and mortality rates are low. It appears particularly important to enforce prescription of beta-blockers at discharge is an important goal in this population.