Long-term follow-up of patients treated with coronary angioplasty for acute myocardial infarction.

Long-term follow-up data for patients treated with coronary angioplasty (PTCA) for acute myocardial infarction are limited. Therefore the long-term outcome of 336 consecutive patients treated with PTCA at a median of 4.5 hours (range 0.5 to 48 hours) from symptom onset was evaluated. The in-hospital mortality was 11.1% (37 patients). Follow-up is complete for 293 of 299 (98%) hospital survivors at a median of 24 months. Of patients discharged, the mean age was 55 +/- 11 years, 49% received intravenous thrombolytic therapy, 53% had multivessel coronary artery disease, and the mean ejection fraction was 48 +/- 10%. Post-discharge survival was 96.1% at 1 year and 93.6% at 2 years by life table analysis. Post-discharge survival was independently predicted by no prior myocardial infarction (96.9% versus 87.3% 2-year survival, p less than 0.001 by log rank analysis) and infarct artery patency at hospital discharge (which had its major impact on survival early after hospital discharge: [97.4% versus 93.4% 1-year survival but 94.2% versus 93.4% 2-year survival; overall p = 0.02]). For patients with analyzable ventriculograms at hospital discharge, ejection fraction greater than or equal to 40% was also a significant independent predictor of survival (98.1% versus 85.8% 2-year survival, p = 0.01). For patients with a successful PTCA, time from symptom onset to catheterization and angioplasty less than or equal to 4 hours versus greater than 4 hours was also an independent predictor of outcome (97.1% versus 91.4% 2-year survival; p = 0.04).(ABSTRACT TRUNCATED AT 250 WORDS)