Independent prognostic value of the extent and severity of systolic wall thickening abnormality at infarct site after thrombolytic therapy, ,

Background: The prognostic value of systolic wall thickening abnormality after acute myocardial infarction in the thrombolytic era is not clearly known. Methods and Results: Accordingly, 119 consecutive patients with acute myocardial infarction who underwent thrombolysis were investigated with exercise electrocardiography and rest echocardiography at predischarge evaluation and were followed up for cardiac events. During a mean follow-up period of 19 months, 43 patients had cardiac events. Multivariate analysis with clinical, exercise electrocardiographic, and rest echocardiographic parameters showed that the independent predictors of cardiac events were systolic wall thickening score at the site of infarct (p = 0.02), end-systolic volume (p = 0.03), and exercise time (p = 0.02). The only independent predictor for both recurrent ischemic (death, unstable angina, and reinfarction) and nonischemic events (congestive heart failure and ventricular tachycardia) was systolic wall thickening score at the site of infarct (p = 0.02 and p = 0.007, respectively). Conclusions: Systolic wall thickening abnormality at rest is an important independent predictor of cardiac events in patients who have undergone thrombolysis after acute myocardial infarction. (Am Heart J 1998;135:1093-8.)