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

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.