A
couple decades ago, a patient was considered at high risk for Post Operative cardiac complication(PCC) for 6 months
after an MI, and at some increased risk forever.
Today, advances in treatment
of acute coronary syndrome have improved the prognosis after MI.
However, as
shown by Van Belle’s angiography study of 56 post-MI patients, plaques remain
unstable and vulnerable to reocclusion for at least 4 weeks, even after
thrombolysis.
Now the high-risk period is 6 weeks, with a period of relative
risk from 6–12 weeks. In this relative-risk period, cardiac function is more
important than time
Van
Belle E, Lablanche J-M, Bauters C, Renaud N, McFadden EP, Bertrand ME.
Coronary
angioscopic findings in the infarct- related vessel within 1 month of acute myocardial
infarction: natural history and the effect of thrombolysis. Circulation 1998;97(1):26–33.
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