Objective : Early reperfusion and sustained patency of the infarct related coronary artery are important determinants of survival in patients with myocardial infarction- Althrough many clinical studies have been made to assess the value of non invasive markers to predict coronary patency ,only a limited number of studies prospectively assessed the role of non invasive prediction strategy for early patency assessment in comparison with angiography in China- Therefore , we assessed the value of non invasive markers to predict reperfusion and patency in the context ofthe angiography in TUCCsubstudy- The present prospectively designed study aimed to compare the predictive power of non invasive markers with that of angiographyfor patency ofinfarct related vessels after thrombolytic therapy- Methods:In TUCC substudy , 219 patients with their first acute myocardial infarction underwent assessment of four non invasive markers including ST segment monitoring , cardiac enzyme determinations , chest pain resolution and reperfuion arrhythmias- Simultaneous coronary angiography at 90 min following thrombolytic therapy was performed- The angiograms were evaluated for flow in infarct related vessels using the classification ofthe thrombolysis in myocardial infarction trial (TIMI) at first injection of contrast agent- TIMIperfusion grade 0 ～1 indicated an occluded coronary artery , TIMIperfusion grade 2 ～3 a reopened artery- According to the TIMIperfusion grade ,219 patients were divided into two groups : Patency group ,141 cases ;the occluded group ,78 cases- In orderto evaluate the value of non invasive markers , we compared and analyzed all clinical data and coronary angiograms in both groups ,including complications and mortality- The study showed no difference in general clinical status between two groups ,including age , risk factors , myocardial infarction location ,infarct related coronary artery , cardial function and blood pressure ( p > 0-05)- Results : The study showed that STsegment recovery in patency group was very significant as compared with thatin the occluded group ( p < 0-01)- Ninty one patients (68-9 % ) in patency group had ≥50 % STrecovery at 90 min afterinitiation ofthrombolytictherapy ,but only 17 patients (23-9 % ) in occluded group ( p < 0-01)- The sensitivity , specificity , positive and negative predictive rate at 90 min were 68-9 % , 76-1 % , 84-3 % and 56-9 % ,respectively- The sensitivity and specificity were 25-7 % and 94-7 % at 30 min for a reduction of ST segment elevation ≥ 50 % ,and it was 80-5 % and 64-9 % at 120 min- Cardiac enzyme activity (CK and CK MB) peak values in patency group were lower than in occluded group- The mean valuefor peak CKin patency group was 2 234-7 ±1 375-6 U/liter ,and 3 087-2 ±2 193-3 U/literin occluded group ( p < 0-001)- The mean value for CK MBin patency group was 159-4 ±123-3 U/liter ,and 227-5 ±395-8 in occluded group ( p < 0-05)- The time to peak value was 13-3 ±3-9 h in patency group ,and 17-6 ±9-8 h in occluded groups ( p < 0-01)- The reperfusion arrhythmias were documented in 74-5 % of patients in patency group , however ,46-6 % in occluded group had reperfusion arrhythmias- There was significant difference between these two groups- The chest pain resolution was observed in 191 patients- 82-3 % patients in patency group had a chest pain resolution at 90 min , only 44-8 % in occluded group ,there was statistical difference between two groups ( p < 0-01)- Conclusion : We concluded that non invasive makers may help toi predict reperfusion and coronary artery patency , especially ≥50 % ST segment redution and early cardiac enzyme activity peak value and that permits accurate prediction of coronary patency in acute myocardialinfarction undergoing thrombolytic therapy- Objective: Early reperfusion and sustained patency of the infarct related coronary artery are important determinants of survival in patients with myocardial infarction- Althrough many clinical studies have been made to assess the value of non invasive markers to predict coronary patency, only a limited number of studies prospectively assessed the role of non invasive prediction strategy for early patency assessment in comparison with angiography in China- Therefore, we assessed the value of non invasive markers to predict reperfusion and patency in the context of the angiography in TUCCsubstudy- The present prospectively designed study aimed to compare the predictive power of non invasive markers with that of angiography for patency of infarct related vessels after thrombolytic therapy-Methods: In TUCC substudy, 219 patients with their first acute myocardial infarction underwent assessment of four non-invasive markers including ST segment monitoring, cardiac enzyme determ inations, chest pain resolution and reperfuion arrhythmias- Simultaneous coronary angiography at 90 min following thrombolytic therapy was performed- The angiograms were evaluated for flow in infarct related vessels using the classification of the thrombolysis in myocardial infarction trial (TIMI) at first injection of contrast agent- TIMI perfusion grade 2 ~ 3 a reopened artery - According to the TIMIperfusion grade, 219 patients were divided into two groups: Patency group, 141 cases; the occluded group, 78 cases - In orderto evaluate the value of non invasive markers, we compared and analyzed all clinical data and coronary angiograms in both groups, including complications and mortality- The study showed no difference in general clinical status between two groups, including age, risk factors, myocardial infarction location, infarct related coronary artery, cardial function and blood pressure (p> 0-05) - Results: The study showed that ST segment recovery in patency group was very significant as compared with that in the occluded group (p <0-01) - Ninty one patients (68-9%) in patency group had ≥50% STrecovery at 90 min after initiation The sensitivity, specificity, positive and negative predictive rate at 90 min were 68-9%, 76-1%, 84-3 (p <0.01) % and 56-9%, respectively- The sensitivity and specificity were 25-7% and 94-7% at 30 min for a reduction of ST segment elevation ≥ 50%, and it was 80-5% and 64-9% at 120 min- Cardiac enzyme activity (CK and CK MB) peak values ​​in patency group were lower than in occluded group- The mean value for peak CKin patency group was 2 234-7 ± 1 375-6 U / liter, and 3 087-2 ± 2 193-3 U / liter occluded group (p <0-001) - The mean value for CK MBin patency group was 159-4 ± 123-3 U / liter, and 227-5 ± 395-8 in occluded group ( p <0-05) - The time to peak value was 13-3 ± 3-9 h in patency group, and 17-6 ± 9-8 h in occluded groups (p <0-01) - The reperfusion arrhythmias were documented in 74-5% of patients in patency group, however , 46-6% in occluded group had reperfusion arrhythmias- There was a significant difference between these two groups- The chest pain resolution was observed in 191 patients- 82-3% patients in patency group had a chest pain resolution at 90 min, only 44 -8% in occluded group, there was statistical difference between two groups (p <0-01) - Conclusion: We concluded that non-invasive makers may help to predict predictors of reperfusion and coronary artery patency, especially> 50% of ST segment redution and early cardiac enzyme activity peak value and that permits accurate prediction of coronary patency in acute myocardial infarction undergoing thrombolytic therapy-