957-108 Does Reperfusion Induced by Angioplasty Confer the Same Benefit as Thrombolysis in Terms of Late Potentials?

Angioplasty or thrombolysis (T) during acute myocardial infarction (MI) are two effective methods for achieving reperfusion, but whether reperfusion induced by angioplasty confers the same protection against the presence of late potentials on signal-averaged electrocardiography (SAE) as that induced by T remains debated. We studied retrospectively 102 consecutive Pts with successful reperfusion (TIMI grade 3 patency in acute phase), obtained by T, primary angioplasty (P), or rescue angioplasty (R) during the first 6 hours of MI. T Pts all had angiography at 90 min to prove reperfusion. All had SAE g 6 days later. Late potentials were defined as, ≥ 2 of the following criteria: QRS g 120 msec, RMS 40 l 20 μV, LAS g 38 msec. Results are (mean ± SD): T P R P number of Pts 35 40 27 Age (years) 59.9 ± 11 60.5 ± 14 53 ± 13 l 0.04 % males 86 85 93 NS % anterior 54 58 46 NS Time to treatment (min) 169 ± 72 212 ± 79 171 ± 76 NS Time to reperfusion (min) 285 ± 75 * 261 ± 90 280 ± 98 NS Ejection fraction ° (%) 53 ± 8 45 ± 15 46 ± 14 NS % Late potentials 43 10 11 l 0.001 * time to 90 min angiography with proven reperfusion ° radionuclide left ventricular ejection fraction at discharge Thus, after MI, the prevalence of late potentials appears lower when acute reperfusion is obtained by angioplasty rather than by thrombolysis. This difference does not appear related to differences in time to treatment, time to reperfusion, left ventricular function or other patient characteristics.