Dlouhodobá prognóza nemocných s akutníminfarktem myokardu při léčbě přímou koronárníangioplastikou

Long-Term Prognosis for Patients with AcuteMyocardial Infarction Treatedwith Primary Coronary Angioplasty

Background.
Primary coronary angioplasty (PTCA) has a beneficial effect on the immediate prognosis for patientswith acute myocardial infarction. Number of information about effects of direct PTCA on the long-term prognosisare less numerous. The aim of the work was to establish the long-term prognosis for not-selected patients treated bydirect PTCA.Methods and Results. The studied group consisted of 279 patients with acute myocardial infarction treated by directPTCA in years 1995 to 1999 for the period of 38±12 months. Part of them were out-door patients of our clinic. Thenecessary data of the other patients were obtained by a questionnaire and by a telephone contact. 45 (16 %) patientswere lost from the follow up. The mortality rate of the study group was compared with data in the central registerof Czech Republic. Positive angiographic effect of the direct PTCA (residual stenosis 70 years, ejectionfraction 4 hours,and diabetes mellitus. The total mortality was 11,4 % in the first year, 1,4 % in the second and 3,3 % in the thirdyear of the follow up.Conclusions. The beneficial prognostic effect of the direct PTCA on patients with acute infarction carries throughthe whole period of follow up. Prognosis of the risk patients remains critical. Next revascularization of the infarctedartery was in our cohort of patients necessary in 21 % of patients.

Key words:
primary coronary angioplasty, myorardial infarction, revascularization.