Degree of activity at the onset of myocardial infarction and thrombolysis outcome

• Published in: International journal of cardiology Vol. 92; no. 1; pp. 35 - 41
• Main Authors: Zairis, Michael N., Psaltiras, George P., Papadaki, Olga A., Psarogianni, Paraskevi K., Lyras, Anastassios G., Giannakopoulos, Andreas K., Andrikopoulos, George K., Adamopoulou, Evdokia N., Olympios, Christopher D., Foussas, Stefanos G.
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01.11.2003; Elsevier Science
• Subjects: Acute myocardial infarction; Adult; Aged; Biological and medical sciences; Blood. Blood coagulation. Reticuloendothelial system; Female; Fibrinolytic Agents - therapeutic use; Health Status; Hospital Mortality; Humans; Male; Medical sciences; Middle Aged; Myocardial Infarction - drug therapy; Myocardial Infarction - physiopathology; Pathophysiology; Pharmacology. Drug treatments; Physical activity; Physical Fitness; Prognosis; Prospective Studies; ST elevation; Streptokinase - therapeutic use; Thrombolysis outcome; Thrombolytic Therapy; Tissue Plasminogen Activator - therapeutic use; Treatment Outcome; ST elevation; Physical activity; Thrombolysis outcome; Pathophysiology; Acute myocardial infarction; Physical exercise; Human; Intravenous administration; Infarct; Coronary artery; Cardiovascular disease; Coronary heart disease; Myocardial disease; Fibrinolysis; Chemotherapy; Treatment; Myocardium; Rehabilitation(human); Evolution
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/S0167-5273(03)00041-X

Background: The aim of this study was to evaluate the possible relationship between the degree of physical activity at the onset of myocardial infarction and thrombolysis outcome. Methods: A total of 351 consecutive patients, who underwent thrombolysis due to ST elevation acute myocardial infarction, were prospectively studied. Patients were classified into three groups according to a generally accepted scale: group I patients had experienced symptoms during exertion, group II when sitting and group III during sleep or when reclining. Results: There was a significantly increased chance of either intravenous thrombolysis effectiveness or cardiac survival probability with increasing physical activity at the onset of myocardial infarction. In particular, group I patients had a significantly higher incidence of complete ST-segment resolution ( P<0.001 for both II vs. I and III vs. I groups) or TIMI 3 flow in the infract-related artery (II vs. I: P=0.002, and III vs. I: P<0.001) and less compromised left ventricular function ( P<0.001 for both II vs. I and III vs. I) by both univariate and multivariate analysis. Moreover, although the degree of physical activity was associated with lower in-hospital (II vs. I: P=0.048, and III vs. I: P=0.01), and cardiac mortality at 39 months (II vs. I: P=0.002, and III vs. I: P<0.001) by univariate analysis, this did not hold true by multivariate analysis. Conclusions: In conclusion, the degree of physical activity at the onset of myocardial infarction may be positively associated with acute success of intravenous thrombolysis and this may favorably influence short- and long-term cardiac survival.