The prognostic importance of two easily obtainable noninvasive markers after intravenous thrombolytic therapy in acute myocardial infarction.

The predictability of left ventricular function, short- and long-term prognosis, assessed by means of two easily obtainable noninvasive markers, was prospectively studied in 110 consecutive patients undergoing thrombolytic therapy for acute myocardial infarction. Positive noninvasive markers were defined as follows: a) > 50% reduction in ST segment elevation within 120 min of initiating therapy, and b) early peak of creatine kinase (CK) activity < 12h after the start of thrombolysis. Seventy-five (68%) of the patients had two positive markers and are classified as the responder group. The nonresponder group consisted of 35 patients (32%) who had 0-1 positive markers. Left ventricular function was assessed 6-12 weeks after therapy by equilibrium radionuclide ventriculography. Left ventricular ejection fraction (LVEF) and survival rates at 1 month and 36 months were significantly higher in the responder group compared to the nonresponder group (54 +/- 12% vs. 43 +/- 11%, P < 0.05; 99% vs. 89%, P < 0.06; and 95% vs. 80%, P < 0.05 respectively). Thus, the combined analysis of two easily obtainable noninvasive markers can predict post-treatment preservation of left ventricular function and survival up to 36 months in patients with acute myocardial infarction undergoing thrombolytic therapy.