Effect of thrombolytic therapy on the incidence of early left ventricular infarct expansion in acute anterior myocardial infarction.

OBJECTIVES To determine the incidence of early left ventricular infarct expansion within five days after first anterior ST-segment elevation myocardial infarction and the effect of early thrombolytic therapy on the incidence of early infarct expansion compared with late thrombolytic therapy. METHODS In a prospective study of 101 patients (75males and 26 females), with the first attack of acute anterior myocardial infarction, their ages ranged from 40-80 years (mean age: 61.07±10.78) who had been admitted to the Coronary Care Unit of Hawler Teaching Hospital for the period from July 2007 through to September 2009. Those who received alteplase ≤3 hours of acute myocardial infarction were labelled as group-I (49 patients) and those who received alteplase >3-12 hours were labelled as group-II (52 patients). RESULTS The incidence of early left ventricular infarct expansion was diagnosed by 2D-echocardiography and was found to be 17.8%. Group I patients had a lower incidence of early left ventricular infarct expansion (8.16%) compared with group-II (26.92%; p=0.014). Patients with early left ventricular infarct expansion had a higher frequency rate of left ventricular systolic dysfunction (94.44%) compared to patients without early left ventricular infarct expansion (8.43%; p<0.001). There was a significant difference in the incidence of in-hospital mortality between the patients who developed early left ventricular infarct expansion (11.1%) compared with patients without early left ventricular infarct expansion (1.2%; p=0.025). CONCLUSION Early reperfusion therapy in acute anterior myocardial infarction can decrease the incidence of early left ventricular infarct expansion, preserve left ventricular systolic function and decrease in-hospital mortality.