The Box: Cost-utility of an eHealth intervention in the outpatient clinic follow-up of acute myocardial infarction patients. (Preprint)

2021 ◽  
Author(s):  
Roderick Willem Treskes ◽  
M. Elske van den Akker ◽  
Loes A.M. van Winden ◽  
Nicole van Keulen ◽  
Enno T. van der Velde ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Outpatient Clinic ◽  
Remote Monitoring ◽  
Cost Utility ◽  
Cost Of Care ◽  
Control Group ◽  
Life Years ◽  
Ehealth Intervention

BACKGROUND Smartphone compatible wearables have been released on the consumers market, enabling remote monitoring. Remote monitoring is often named as a tool to reduce cost of care. OBJECTIVE The primary purpose of this paper is to describe a cost-utility analysis of an eHealth intervention compared to regular follow-up in patients with acute myocardial infarction (AMI). METHODS In this trial, patients with an AMI were randomized in a 1:1 fashion between an eHealth intervention and regular follow-up. The remote monitoring intervention consisted of a blood pressure monitor, weight scale, electrocardiogram (ECG) device and step counter. Furthermore, two in-office outpatient clinic visits were replaced by e-visits. The control group received regular care. The differences in mean costs and quality of life per patient between both groups during one year follow-up were calculated RESULTS Mean costs per patient were €2412 for the intervention, and €2888 for the control group. This yielded cost reduction of €475 per patient. This difference was not statistically significant (95% CI -€271;€1221; P=.212). The average quality adjusted life years (QALY) in the first year of follow was 0.74 for the intervention group and 0.69 for the control (difference -0.05, 95% CI -0.09;-0.01; P=.028). CONCLUSIONS eHealth in the outpatient clinic setting in patients who suffered from acute myocardial infarction is very likely to be cost-effective compared to regular follow-up. Further research should be done to corroborate these findings in other patient populations and different care settings. CLINICALTRIAL NCT02976376 INTERNATIONAL REGISTERED REPORT RR2-10.2196/resprot.8038

scholarly journals Association of Tooth Scaling with Acute Myocardial Infarction and Analysis of the Corresponding Medical Expenditure: A Nationwide Population-Based Study

2021 ◽  
Vol 18 (14) ◽  
pp. 7613
Author(s):  
Yi-Wei Kao ◽  
Ben-Chang Shia ◽  
Huei-Chen Chiang ◽  
Mingchih Chen ◽  
Szu-Yuan Wu
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Periodontal Diseases ◽  
Population Based ◽  
Medical Expenditure ◽  
Control Group ◽  
Proportional Hazard ◽  
Population Based Study ◽  
Scaling Group

Accumulating evidence has shown a significant correlation between periodontal diseases and systemic diseases. In this study, we investigated the association between the frequency of tooth scaling and acute myocardial infarction (AMI). Here, a group of 7164 participants who underwent tooth scaling was compared with another group of 7164 participants without tooth scaling through propensity score matching to assess AMI risk by Cox’s proportional hazard regression. The results show that the hazard ratio of AMI from the tooth scaling group was 0.543 (0.441, 0.670) and the average expenses of AMI in the follow up period was USD 265.76, while the average expenses of AMI in follow up period for control group was USD 292.47. The tooth scaling group was further divided into two subgroups, namely A and B, to check the influence of tooth scaling frequency on AMI risk. We observed that (1) the incidence rate of AMI in the group without any tooth scaling was 3.5%, which is significantly higher than the incidence of 1.9% in the group with tooth scaling; (2) the tooth scaling group had lower total medical expenditures than those of the other group because of the high medical expenditure associated with AMI; and (3) participants who underwent tooth scaling had a lower AMI risk than those who never underwent tooth scaling had. Therefore, the results of this study demonstrate the importance of preventive medicine.

Abstract 19312: A Follow-up Study of Coronary Vasomotor Function in Ischemic and Remote Myocardium Following Successful Percutaneous Revascularization for Acute Myocardial Infarction - a [15O]H2O PET Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Paul F Teunissen ◽  
Stefan A Timmer ◽  
Ibrahim Danad ◽  
Hans J Harms ◽  
Pieter G Raijmakers ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Left Ventricular ◽  
Remote Myocardium ◽  
Control Group ◽  
Infarcted Myocardium ◽  
Vasomotor Function ◽  
Flow Reserve ◽  
Coronary Vasomotor Function

Introduction: In patients with acute myocardial infarction (AMI), coronary vasomotor function is not only impaired in the myocardial territory supplied by the culprit-artery but also in remote myocardium supplied by angiographically normal vessels. Aims: The aim was to investigate the temporal evolution of coronary vasodilatory reserve in patients with AMI by use of [15O]H2O PET, after successful percutaneous coronary intervention (PCI). Methods: Fourty-four patients with AMI and successful revascularization by PCI were included (i.e. TIMI II or III flow after coronary stenting). Subjects were examined one week and three months after AMI with [15O]H2O PET to assess the coronary flow reserve (CFR). CFR was defined as the ratio of myocardial blood flow during hyperemia (hMBF) and rest (MBF). Additionally, 45 age and sex matched subjects without a prior cardiac history underwent similar scanning procedures and served as a control group. Results: At baseline, CFR averaged 1.77 ± 0.63 in infarcted myocardium versus 2.41 ± 0.79 in remote myocardium (p < 0.001). In comparison, CFR in the control group averaged 4.16 ± 1.45 (p = 0.001 versus both). During follow-up, the CFR increased from 1.77 ± 0.63 to 2.75 ± 0.89 in infarcted myocardium (p < 0.001), and from 2.41 ± 0.79 to 2.85 ± 0.75 in remote myocardium (p = 0.001). This was predominantly due to an increase in hMBF, from 1.64 ± 0.54 to 2.19 ± 0.74 mL/min/g in infarcted myocardium (p < 0.001), and 2.20 ± 0.56 to 2.61 ± 0.65 mL/min/g in remote myocardium (p = 0.001). Conclusions: Coronary vasodilatory reserve is impaired in both ischemic and remote myocardium directly after AMI. Following successful revascularization, the coronary vasodilatory reserve significantly improved in both regions. As a consequence, these early and late post-infarct alterations in remote myocardium may also affect temporal infarct evolution and recovery of left ventricular function.

Abstract 341: Cost of Care Implications for Unstable Angina and Coronary Revascularization Readmissions Following Acute Myocardial Infarction

2015 ◽  
Vol 8 (suppl_2) ◽  
Author(s):  
Kim Smolderen ◽  
Kevin Kennedy ◽  
Suzanne Arnold ◽  
Paul Chan ◽  
Jae-Sik Jang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Unstable Angina ◽  
Coronary Revascularization ◽  
Cost Of Care ◽  
Office Visits ◽  
Post Discharge ◽  
Bootstrap Analysis ◽  
Life Years ◽  
Mean Differences

Objectives: While mortality following acute myocardial infarction (AMI) has decreased over time, subsequent hospitalizations due to unstable angina (UA) and coronary revascularization (CR) continue to be a great source of burden both from a patient’s and a societal perspective. It is unknown, however, how AMI patients who experience these additional readmissions value their health and what the associated costs are, beyond the hospitalization itself. Methods: From TRIUMPH, a 24-center observational AMI registry, we identified patients readmitted for unstable angina (UA) or unplanned CR ≥1 month following index AMI discharge. Propensity matching was used to compare (1) patients who were vs. were not readmitted for UA and (2) patients who were vs. were not readmitted for CR. We examined one-year quality-adjusted life-years (QALYs) using the EQ-5D measurements at 1, 6 and 12 months, as well as post-discharge costs (office visits, cardiac rehabilitation and cardiovascular readmissions, excluding costs for the UA/CR event). Confidence intervals were calculated via bootstrap analysis. Results: A total of 140 (4.26%) were readmitted for UA and 112 (3.41%) patients underwent CR after their AMI. Unadjusted mean 1-year QALYs for UA and non-UA patients were 0.743 and 0.821 [propensity-matched difference -0.076 (95% CI -0.100, -0.042)]. Unadjusted mean 1-year QALYs for CR and non-CR patients were 0.798 and 0.828 [propensity-matched difference -0.032 (95% CI -0.063, -0.003]. Mean differences in costs were $8009 (95% CI $3997, $14229) for UA vs. non-UA patients and $4498 (95% CI $4046, $4966) for CR vs. non-CR patients. Cardiovascular rehospitalizations contributed most to these costs (Table) . Conclusion: In this study, over the year following AMI, patients experiencing UA or unplanned coronary revascularization were challenged in maintaining their health status as compared with those not experiencing the respective event and had significantly higher health care costs.

scholarly journals Long-term outcome of patients with invasive electrophysiology procedure-related cardiac tamponade

EP Europace ◽  
2020 ◽  
Vol 22 (10) ◽  
pp. 1547-1557
Author(s):  
Gesa von Olshausen ◽  
Tara Bourke ◽  
Jonas Schwieler ◽  
Nikola Drca ◽  
Hamid Bastani ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Cardiac Tamponade ◽  
Cardiovascular Events ◽  
Control Group ◽  
Risk Of Death ◽  
Increased Risk

Abstract Aims Iatrogenic cardiac tamponades are a rare but dreaded complication of invasive electrophysiology procedures (EPs). Their long-term impact on clinical outcomes is unknown. This study analysed the risk of death or serious cardiovascular events in patients suffering from EP-related cardiac tamponade requiring pericardiocentesis during long-term follow-up. Methods and results Out of 19 997 invasive EPs at the Karolinska University Hospital between January 1998 and September 2018, all patients with EP-related periprocedural cardiac tamponade were identified (n = 60) and matched (1:3 ratio) to a control group (n = 180). After a follow-up of 5 years, the composite primary endpoint — death from any cause, acute myocardial infarction, transitory ischaemic attack (TIA)/stroke, and hospitalization for heart failure — occurred in significantly more patients in the tamponade than in the control group [12 patients (20.0%) vs. 19 patients (10.6%); hazard ratio (HR) 2.53 (95% confidence interval, CI 1.15–5.58); P = 0.021]. This was mainly driven by a higher incidence of TIA/stroke in the tamponade than in the control group [HR 3.75 (95% CI 1.01–13.97); P = 0.049]. Death from any cause, acute myocardial infarction, and hospitalization for heart failure did not show a significant difference between the groups. Hospitalization for pericarditis occurred in significantly more patients in the tamponade than in the control group [HR 36.0 (95% CI 4.68–276.86); P = 0.001]. Conclusion Patients with EP-related cardiac tamponade are at higher risk for cerebrovascular events during the first 2 weeks and hospitalization for pericarditis during the first months after index procedure. Despite the increased risk for early complications tamponade patients have a good long-term prognosis without increased risk for mortality or other serious cardiovascular events.

scholarly journals Cost–utility analysis of remote versus conventional monitoring of pacemakers in the Arctic Circle

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Lopez-Villegas ◽  
D Catalan-Matamoros ◽  
S Peiro ◽  
K T Lappegard ◽  
R Lopez-Liria
Keyword(s):  
Remote Monitoring ◽  
National Health System ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
The Arctic ◽  
Utility Analysis ◽  
System Perspective ◽  
Life Years ◽  
Monitoring Group

Abstract Introduction Several studies have demonstrated that remote monitoring (RM) of pacemakers is safe, effective and cost-saving. The aim of this study was to perform an economic assessment and check whether RM offers a cost-utility alternative to conventional monitoring in hospital (CM). Methods This is a controlled, randomized, non-masked clinical trial. Fifty patients with pacemaker were assigned to receive either RM (n = 25) or CM (n = 25). Data were collected during the 12 months. A cost-utility analysis was performed in order to assess whether RM of pacemakers is cost-effective compared to CM in hospital in terms of costs per gained quality-adjusted life years (QALY). The analysis was performed from the perspectives of the Norwegian Healthcare System (NHS) and patients. Results Overall, total costs from the NHS perspective were higher in the RM group (€2,079.84 vs. €271.97; p = 0.147). The costs related to the patients perspective were higher in the RM than those in the CM group (€223.99 vs. €158.42, respectively; P = 0.429). Patients included in the CM obtained 0.04 QALYs less than those in the RM group over 12 months and the total costs per QALY comprised €1,784.10 (P = 0.175) per user with a pacemaker implant. The total number of pacemaker transmissions per patient year comprised 86.46% of minors in the CM group. Conclusions The follow-up costs were similar between both groups. Cost-utility analysis showed broad confidence intervals with ICERs ranging from potential savings to high costs for an additional QALY, with most ICERs lower than the usual NHS thresholds for coverage decisions. Key messages Total costs from the National Health System perspective were higher in the remote monitoring group, although there were not significant differences between both groups of follow-up. The costs related to the patient perspective were higher in the remote monitoring than those in the conventional monitoring group, without significant differences.

Long-term outcome of patients with invasive electrophysiology procedure related cardiac tamponade

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
G Von Olshausen ◽  
T Bourke ◽  
J Schwieler ◽  
N Drca ◽  
H Bastani ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Cardiac Tamponade ◽  
Cardiovascular Events ◽  
Control Group ◽  
Funding Source ◽  
Increased Risk

Abstract Aims Iatrogenic cardiac tamponades are a rare but dreaded complication of invasive electrophysiology procedures (EPs). Their long-term impact on clinical outcomes is unknown. This study analyzed the risk of death or serious cardiovascular events in patients suffering from EP related cardiac tamponade requiring pericardiocentesis during long-term follow-up. Methods and results Out of 19997 invasive EPs at our university hospital between January 1998 and September 2018, all patients with EP related periprocedural cardiac tamponade were identified (n=60) and matched (1:3 ratio) to a control group (n=180). After a follow-up of 5 years, the composite primary end point - death from any cause, acute myocardial infarction, TIA/stroke and hospitalization for heart failure – occurred in significantly more patients in the tamponade than in the control group (12 patients (20.0%) vs 19 patients (10.6%); Hazard ratio (HR) 2.53 (95% CI, 1.15–5.58); p=0.021). This was mainly driven by a higher incidence of TIA/stroke in the tamponade than in the control group (HR 3.75 (95% CI, 1.01–13.97); p=0.049). Death from any cause, acute myocardial infarction and hospitalization for heart failure did not show a significant difference between the groups. Hospitalization for pericarditis occurred in significantly more patients in the tamponade than in the control group (HR 36.0 (95% CI, 4.68–276.86); p=0.001). Conclusion Patients with EP related cardiac tamponade are at higher risk for cerebrovascular events during the first two weeks and hospitalization for pericarditis during the first months after index procedure. Despite the increased risk for early complications tamponade patients have a good long-term prognosis without increased risk for mortality or other serious cardiovascular events. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): German Research Foundation

P6217Managed Care after Acute Myocardial Infarction (MC-AMI) reduces MACE by 45% in 3-month follow-up - results form Poland's National Health Fund program of post-MI care. A single center analysis

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Kulach ◽  
K Wita ◽  
M Wita ◽  
M Wybraniec ◽  
K Wilkosz ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
National Health ◽  
Cardiovascular Events ◽  
Cox Regression ◽  
Major Adverse Cardiovascular Events ◽  
Control Group ◽  
Single Center ◽  
Post Discharge

Abstract Background Despite progress in the medical and interventional treatment of acute myocardial infarction (AMI) and low in-hospital mortality related to AMI, a post-discharge prognosis in MI survivors is still unacceptable. The Managed Care in Acute Myocardial Infarction (MC-AMI, KOS-zawal) is a program introduced by Poland's National Health Fund aiming at comprehensive care for patients with AMI to improve long-term prognosis. It includes acute intervention, complex revascularization, cardiac rehabilitation (CR), outpatient follow-up, and prevention of SCD. Aims To assess the effect of MC-AMI on major adverse cardiovascular events (MACE) in a 3-month follow-up. Methods In this single-center, retrospective observational study we enrolled 1211 patients, and compared them to 1130 subjects in the control group. After 1:1 propensity score matching two groups of 529 subjects each were compared. Cox regression was performed to assess the effect of MC-AMI and other variables on MACE. Results MC-AMI has been proved to reduce MACE rate by 45% in a 3-month observation. Multivariable Cox regression analysis revealed MC-AMI participation to be inversely associated with the occurrence MACE at 3 months (HR 0.476, 95% CI 0.283–0.799, p<0.005). Besides, older age, male sex (HR 2.0), history of unstable angina (HR 3.15), peripheral artery disease (HR 2.17), peri-MI atrial fibrillation (HR 1.87) and diabetes (HR 1.5), were significantly associated with the primary endpoint. Comparison of study endpoints between KO Total, n (%) MC-AMI group, n (%) Control Group, n (%) RR 95% CI NNT P n=1058 n=529 n=529 All-cause mortality 19 (1.8%) 7 (1.3%) 12 (2.3%) 0.583 0.232–1.470 105.8 0.247 Hospitalization for HF 31 (2.9%) 12 (2.3%) 19 (3.6%) 0.632 0.310–1.288 75.6 0.202 Myocardial infarction 25 (2.4%) 9 (1.7%) 16 (3.0%) 0.563 0.251–1.262 75.6 0.157 MACE 73 (6.9%) 26 (4.9%)# 47 (8.9%) 0.553 0.348–0.879 25.2 0.012 *Two-tailed Pearson's Chi-square test; MACE, Major Adverse Cardiovascular Events. #Number of patients with at least one MACE; in 2 patients 2 endpoints occurred. This explains why the total number of MACE is lower than the sum of all endpoints. MC-AMI vs. control - MACE in 3 months up Conclusions MC-AMI is the first program of a comprehensive. Participation in MC-AMI – a first comprehensive in-hospital and post-discharge care for AMI patients for AMI patients improves prognosis and reduces MACE rate by 45% as soon as in 3 months.

Bleeding Time and Platelet Volume in Acute Myocardial Infarction – A 2 Year Follow-Up Study

1988 ◽  
Vol 59 (03) ◽  
pp. 353-356 ◽  
Author(s):  
S Dalby Kristensen ◽  
P C Milner ◽  
J F Martin
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Mean Platelet Volume ◽  
Bleeding Time ◽  
Significant Negative Correlation ◽  
Control Group ◽  
Volume Distribution ◽  
Platelet Volume ◽  
Follow Up Study

SummaryThe bleeding time is shortened and the mean platelet volume is increased in the acute phase of myocardial infarction. In this follow-up study we repeated the measurement of the bleeding time, the platelet count and the platelet volume distribution in 18 patients who had suffered from a definite acute myocardial infarction two years before and in 16 control patients who had been admitted with chest pain but no definite myocardial infarction at that time. At the time of follow-up the bleeding time was significantly lengthened in the myocardial infarction group (median values = 169 s and 209 s respectively), whereas it had shortened in the control group (median values = 258 s and 228 s respectively). Comparison of the platelet volume distribution curves of the myocardial infarction patients at time of infarction and 2 years later revealed a significantly higher percentage of small platelets and significantly lower percentages of both medium-sized and large platelets at the time of infarction. These changes in the platelet volume distribution could indicate consumption of medium-sized and large platelets at the time of myocardial infarction. None of the measured variables predicted which of the patients with acute myocardial infarction would subsequently re-infarct or die. In the patients studied with definite ischaemic heart disease (n = 26) a significant negative correlation between bleeding time and mean platelet volume was found. The shortened bleeding time in myocardial infarction is related to the acute event itself or preceeds it, but is reversed two years later.

scholarly journals Prognostic significance of acute bundle branch block in patients with acute myocardial infarction

2008 ◽  
Vol 65 (10) ◽  
pp. 733-737 ◽  
Author(s):  
Vuk Mijailovic ◽  
Igor Mrdovic ◽  
Marina Ilic ◽  
Milika Asanin ◽  
Milena Srdic ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Prognostic Significance ◽  
Total Mortality ◽  
Cardiac Insufficiency ◽  
Control Group ◽  
Bundle Branch Block ◽  
The Right

Background/Aim. Acute bundle branch block (ABBB) presence is associated with the increasing mortality of patients with acute myocardial infarction (AMI). The aim of this study was investigate ABBB influence with respect to in-hospital (IN) and long-term mortality in patients with AIM, as well as total mortality in follow-up, the presence of in-hospital congestive cardiac insufficiency (CCI) and the presence of CCI at follow-up. Methods. This study included 606 consecutive patients with AMI. A total of 415 (68.5%) were males and 191 (31.5%) females, mean age 64.0?11.9. After the dismissal the patients underwent 18-month follow-up period. Results. Acute bundle branch block was registered in 44 patients (7.2%), out of which 15 patients (2.4%) had the left (L) ABBB and 29 patients (4.8%) had the right (R) ABBB. The patients with ABBB showed higher proportion of IH CCI (Killip III and IV) and hypotension compared with the control group (patients without ABBB). In the group of patients with ABBB ?-blockers, statins, aspirin and ACE-inhibitors were less applied. All the three ABBB groups exhibited an increased IH mortality (ABBB 47.7% vs 11.2%, p < 0.01, ARBBB 55.1% vs 11.2% p < 0.01, ALBBB 33.3% vs 11.2%, p < 0.01). Follow-up mortality of the patients with ABBB and ALBBB was higher in comparison with the control group (log-rank p = 0.046 and log-rank p = 0.01, respectively), whereas the group with ARBBB did not show any differences (log-rank, p = 0.59). Conclusion. The patients with ABBB AMI are a risk group of patients that commonly exhibit both early and remote CCI accompanied by high mortality. That is the reason why this sub-group of AMI patients should receive an urgent diagnostics followed by aggressive therapeutic treatment. <br><br><font color="red"><b> This article has been retracted. Link to the retraction <u><a href="http://dx.doi.org/10.2298/VSP0901074U">10.2298/VSP0901074U</a></u></b></font>

EFFICACY OF INTRAVENOUS STREPTOKINASE IN ACUTE MYOCARDIAL INFARCTION: ACUTE AND FOLLOW UP STUDY

1987 ◽  
Author(s):  
R Lochan ◽  
S Tyagi ◽  
B S Yadav ◽  
D K M Rao ◽  
A Bhat ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Left Ventricular ◽  
Control Group ◽  
Coronary Angiogram ◽  
Intravenous Streptokinase ◽  
Follow Up Study ◽  
Group I ◽  
Acute Mi

The efficacy of intravenous streptokinase on recanalization of the 'infarct vessel' and its effect on left ventricular function was assessed in two groups of patients. Group I consisted of 90 consecutive patients (age 32-75 years, mean 56 years) received 500,000 units of intravenous streptokinase (STK) over 30 minutes within 6 hours of onset of acute myocardial infarction (MI). Forty-eight patients had anterior MI and forty-two had inferior MI. The control group consisted of forty survivors of acute MI comparable in age and site of infarction. In Group I, ten patients were administered STK after baseline coronary angiogram demonstrated total occlusion of infarct related coronary artery. In these patients, serial coronary angiogram were done at intervals of 30 minutes after STK infusion upto a period of 3 hours. Recanalization was seen in all cases within 75-135 minutes (average 120 minutes). Seventy-nine of STK group and all of the control group underwent selective coronary arteriography and contrast left ventriculography within 48 to 72 hours of acute MI. Recanalization of infarct related artery was demonstrated in 72 out of 79 patients (91%) in STK group while 8 (20%) in control group had spontaneous recanalization. Left ventricular ejection fraction (LVEF) was higher in STK group (58%) as compared to control group (49%). Among patients with anterior MI, LVEF was significantly better in STK compared to control group (59% Vs. 44%, p > 0.01)while in inferior MI the difference was not significant (63% Vs. 59.4%, p > 0.05) in the two groups. Follow up study in 20 STK patients at 6 months revealed a decrease in residual stenosis from 75 ± 8% to 60 ± 6% and improvement in LVEF from 59 ± 8% to 68 ± 12% (p > 0.01). In conclusion, intravenous STK in acute MI results in high rate of infarct vessel patency and improved global left ventricular function during both early and late follow up period.

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