Risk of complications of early coronary angioplasty after thrombolysis in acute myocardial infarct

: The present study reports on the complication rates in 143 patients who underwent percutaneous transluminal coronary angioplasty (PTCA) within 4 weeks after thrombolysis for acute myocardial infarction. The results were analyzed with respect to the time between thrombolysis and PTCA. PTCA was successful in 130 patients (91%). The mortality was 0.7% (1 patient). Severe complications occurred in 9 further patients (7%): 8 reinfarctions (6%) and one patient with a large haematoma of the groin requiring surgical treatment (0.7%). The total complication rate, including milder was 24%. A comparison of patients treated with PTCA within the first 4 days after thrombolysis (group I, n = 67) with patients dilated between 5 and 28 days after thrombolysis (group II, n = 76) resulted in a complication rate of 33% in group I and 16% in group II (p less than 0.01). This important difference was due to the higher frequency of ischaemic complications in group I than in group II (28% versus 12%). Besides reinfarction (7.5% in group I versus 4% in group II), prolonged ischaemic episodes were the most frequent cause of complications. Our results demonstrate a very high risk of complications if PTCA is performed within the first 4 days after thrombolysis for acute myocardial infarction.