Variables predictive of good functional outcome following thrombolytic therapy in the Thrombolysis in Myocardial Infarction phase II (TIMI II) pilot study.

Academic Article

Abstract

  • Before commencing the randomized Thrombolysis in Myocardial Infarction phase II (TIMI II) study, 370 patients were administered intravenous recombinant tissue plasminogen activator (rt-PA) within 4 hours of onset of acute myocardial infarction (AMI) and assigned to 2-hour (immediate) percutaneous transluminal angioplasty (n = 33), 18- to 48-hour (delayed) angioplasty (n = 288) or no angioplasty (n = 49) in a nonrandomized, observational pilot study. Left ventricular ejection fraction at rest and during exercise was assessed by gated equilibrium radionuclide ventriculography at hospital discharge and again at 6 weeks. At hospital discharge, ejection fraction averaged 50% at rest and 56% at peak exercise. At 6-week follow-up, ejection fraction averaged 50% at rest and 53% at peak exercise. At 6-week follow-up, resting ejection fraction average 49% in the 2-hour angioplasty group, 49% in the 18- to 48-hour angioplasty group and 55% in the no-angioplasty group. Variables independently predicting "good functional outcome" at 6-week follow-up (survival with resting ejection fraction greater than equal to 50% and no decrease with exercise) in the 18- to 48-hour angioplasty group were fewer leads with ST-segment elevation greater than or equal to 0.1 mV, younger age, rapid normalization during rt-PA infusion of ST segments or dramatic relief of chest pain, absence of arrhythmias within the first 24 hours of treatment initiation, no prior infarction and not a cigarette smoker at entry. Thus, the TIMI II pilot study demonstrates that most patients with AMI of less than or equal to 4-hour duration treated with rt-PA have good ventricular function after AMI.(ABSTRACT TRUNCATED AT 250 WORDS)
  • Published In

    Keywords

  • Angiography, Angioplasty, Balloon, Coronary Angiography, Female, Follow-Up Studies, Humans, Male, Middle Aged, Multicenter Studies as Topic, Myocardial Infarction, Myocardial Reperfusion, Pilot Projects, Random Allocation, Recombinant Proteins, Stroke Volume, Time Factors, Tissue Plasminogen Activator
  • Pubmed Id

  • 11726150
  • Author List

  • Rogers WJ; Bourge RC; Papapietro SE; Wackers FJ; Zaret BL; Forman S; Dodge HT; Robertson TL; Passamani ER; Braunwald E
  • Start Page

  • 503
  • End Page

  • 512
  • Volume

  • 63
  • Issue

  • 9