[Long-term results following therapy with streptokinase in myocardial infarct].

Long term results of thrombolytic therapy in myocardial infarction are determined primarily by the effects of treatment in the acute phase. Out of a total of 370 patients undergoing recanalization therapy, 170 consecutive patients were examined over a period of one to three years (mean 1.5 years) by means of ECG, exercise testing, thallium myocardial scintigraphy, radionuclide ventriculography, coronary angiography and contrast ventriculography. Frequency of chest pain, left ventricular function, reinfarction rate and mortality were analyzed. The patient cohort was divided into three subgroups: 1. patients with successful PTCR who underwent PTCA or bypass graft surgery; 2. patients with successful PTCR who were managed medically without subsequent reinfarction; 3. patients with definitive occlusion or reinfarction. Mortality in the hospital phase (within 30 days) was 4.9% in patients undergoing successful recanalization procedures as compared to 12.3% for patients with definitive occlusion. Late mortality at 1.5 years was 12.3% and 16.2%, respectively. These figures are similar to those found in the literature. In-hospital mortality is clearly reduced by early recanalization within 200 minutes of occlusion, and there is a reduction in the ultimate extent of infarction as well as improvement in left ventricular function. In order to prevent reocclusion (in 10 to 20% of cases) and reinfarction additional interventions such as PTCA or bypass grafting should be employed as soon as possible in suitable cases.(ABSTRACT TRUNCATED AT 250 WORDS)