Abstract
A total of 38 consecutive patients with acute myocardial infarction (MI) ineligible to i.v. thrombolysis underwent immediate, selective coronary angiography. Thereafter, percutaneous transluminal coronary angioplasty (PTCA) of the occluded artery was attempted if the infarct-related vessel showed TIMI 0, I, or II-flow. All patients were ineligible to i.v. thrombolysis because of advanced age (80 years) or increased risk of bleeding complications. TIMI-flow III was restored in 35/38 patients (92%) with a residual stenosis of < 50% in 34 patients. Hospital survival was 84%. LV ejection fraction was 49 ± 17% after 2 weeks. Therefore, immediate PTCA in patients with acute MI and contraindications to i.v. thrombolysis appears to yield encouraging preliminary results in a group of high risk patients.
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