[Comparison of the clinical efficacy of recombinant tissue-type plasminogen activator thrombolysis with primary coronary stenting in acute myocardial infarction].

OBJECTIVE

To compare the efficacy of low dose recombinant tissue-type plasminogen activator (rt-PA) thrombolysis with primary coronary stenting after acute myocardial infarction (AMI).

METHODS

Of 261 patients with first AMI, 131 patients were performed with low dose rt-PA intravenously, and 130 patients with primary coronary stenting. The clinical efficacy of these two groups was compared.

RESULTS

The age, time from onset of chest pain to hospital presentation and infarct location between these two groups were comparable. The patency rate of infarct-related artery (IRA) in patients with thrombolysis group was significantly lower than that of patients with primary stenting group (P < 0.00001). The recurrent myocardial infarction, selective coronary stenting of patients with thrombolytic therapy were higher than that of patients with primary stenting group (7.6% vs 1.5%, P < 0.05; 20.6% vs 0, P < 0.001, respectively). The LVEF in patients with thrombolysis group was lower than that of stenting group [(55.6 +/- 13.4)% vs (65.8 +/- 9.2)%, P < 0.0001]. Total hospitalization time of thrombolysis group was longer than that of stenting group [(16 +/- 7) days vs (11 +/- 4) days, P < 0.0001]. The mortality of thrombolysis group was higher than that of stenting group, but this difference was not significant (6.1% vs 3.1%, P > 0.05).

CONCLUSIONS

Compared with low dose rt-PA thrombolytic therapy after AMI, primary coronary stenting has a higher patency rate of the IRA, better cardiac function and shorter hospitalization time.