BACKGROUND: Early reperfusion improves left ventricular (LV) function and survival after acute @entity583 ( @entity583 ). Thrombolytic therapy achieves early patency of the @entity1188 artery in about two-thirds of @entity1 . In nearly half of the remaining @entity1 , in whom early reperfusion was not achieved with thrombolytic therapy, the @entity1188 artery might reopen by the time of predischarge angiography. However, the impact of such late spontaneous reperfusion after failed thrombolytic therapy on LV function and long-term survival remained unclear. HYPOTHESIS: This study was undertaken to assess implication of late spontaneous reperfusion after failed thrombolytic therapy on LV function and long-term survival after acute @entity583 . METHODS: The study consisted of 198 @entity1 with anterior acute @entity583 who underwent thrombolytic therapy and predischarge angiography: 160 @entity1 with @entity1188 artery patent early and late after therapy (persistent patency), 17 @entity1 with @entity1188 artery occluded early after therapy but patent at predischarge angiography (late spontaneous reperfusion), and 21 @entity1 with @entity1188 artery occluded early and late after therapy (persistent occlusion). RESULTS: Persistent patency was associated with enhanced improvement in LV ejection fraction (7.7 +/- 11.8%) compared with late spontaneous reperfusion (0.0 +/- 9.6%, p = 0.03) and persistent occlusion (-1.4 +/- 9.7%, p = 0.003). Persistent patency was associated with better long-term survival than with late spontaneous reperfusion (p < 0.001) and persistent occlusion (p < 0.001). Multivariate analysis comparing persistent patency and late spontaneous reperfusion showed that early reperfusion was an independent predictor of long-term survival. CONCLUSION: Late spontaneous reperfusion after failed thrombolytic therapy was associated with poor LV function and long-term survival, emphasizing the importance of early reperfusion.

Long-term prognosis of late spontaneous reperfusion after failed thrombolysis for acute XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity583 :: ('MESH:D009203', 'Disease') :: ['myocardial infarction', 'MI'] @entity1188 :: ('MESH:D007238', 'Disease') :: ['infarct']
@entity583 :: (MESH:D009203,Disease) :: ['myocardial infarction']
