Search Results
Results 501 - 550 of 1101
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Meehan T P - - 1995
OBJECTIVE: To evaluate the feasibility of linking claims-based pattern analysis with medical record review in the assessment of quality of hospital care among Medicare beneficiaries with acute myocardial infarction. DESIGN: An analysis of risk-adjusted mortality after hospital admission for acute myocardial infarction using the regression model from the Health Care ...
Tapson V F - - 1995
Massive PE is a devastating clinical entity often undiscovered until autopsy. Acute right ventricular failure may progress to death within minutes to hours after the embolic event and prompt diagnostic and therapeutic intervention are imperative. The diagnosis heavily relies on clinical suspicion together with ventilation-perfusion scanning. Echocardiography may have a ...
Goldhaber S Z - - 1995
Thrombolytic therapy for venous thromboembolism is returning, especially for the management of acute pulmonary embolism patients who present with either hypotension or with right ventricular dysfunction despite an initially normal blood pressure and heart rate. Clinicians have learned to use thrombolysis to improve efficacy, minimize bleeding complications, and achieve savings ...
Collen D - - 1995
Despite their widespread use in patients with acute myocardial infarction, all currently available thrombolytic agents suffer from a number of significant limitations, including resistance to reperfusion, the occurrence of acute coronary reocclusion, and bleeding complications. Several lines of research towards improvement of thrombolytic therapy are being explored, including strategies to ...
Smith S M - - 1995
Acute myocardial infarction is a devastating cardiac clinical event, which is the result of progressive coronary arteriosclerosis. Coronary heart disease is a major health concern that accounts for a significant number of hospitalizations, health care expenditures, and deaths. Recent advancements in the nature and pathophysiology of progressive coronary disease and ...
Levine M N - - 1995
There is renewed interest in the treatment of acute deep vein thrombosis and acute pulmonary embolism with thromboembolytic therapy because of the demonstrated mortality reduction in patients with acute myocardial of the demonstrated mortality reduction in patients with acute myocardial infarction and because of the development of newer, fibrin-specific drugs. ...
Mahanonda N - - 1995
In summary, the amount of research in the field of thrombolysis done in patients with acute myocardial infarction has shown the enormous benefit not only for mortality but other cardiovascular events. Its benefit over other non cardiac conditions are accumulating. Several large-scale studies are underway and expected to give us ...
Kalish S C - - 1995
OBJECTIVE: To assess the short- and long-term costs and clinical and quality of life outcomes with the use of streptokinase (SK) vs tissue plasminogen activator (tPA) for acute myocardial infarction (MI). DESIGN: A decision analysis model. PATIENTS: Patients with acute MI who were candidates for thrombolytic therapy and who presented ...
Smalling R W - - 1995
BACKGROUND: Early restoration and maintenance of normal (TIMI 3) blood flow during acute myocardial infarction is critical for optimal preservation of left ventricular function and survival. Recombinant plasminogen activator (r-PA, reteplase) is a nonglycosylated deletion mutant of wild-type tissue-type plasminogen activator (TPA) that has been shown to achieve more rapid ...
de Bono D P - - 1995
Considering the enormous increase in the use of thrombolytic therapy over the last decade, many of the early concepts of thrombolytic therapy have proved to be remarkably robust. Early and sustained restoration of coronary patency remains the ultimate goal. Streptokinase is still extensively used despite evidence that alteplase may, under ...
Hennekens C H - - 1995
Data are now available from three large-scale randomized trials that directly compare the risks and benefits of thrombolytic agents in acute myocardial infarction. In the interpretation of results from the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI-2) trial and its International Extension, the Third International Study of ...
Goff D C DC - - 1995
Little is known regarding the use and effectiveness of thrombolytic therapy in community settings, especially regarding the receipt of therapy by Mexican Americans. Thus, we examined the factors associated with receipt of thrombolysis and the survival experience of recipients and nonrecipients in the Corpus Christi Heart Project. The Corpus Christi ...
Sekyema Y F - - 1995
A 39-year-old female presented to the Emergency Department during the fourth day of menstruation and within 2 hours of the onset of chest pain associated with dyspnea, diaphoresis, and emesis. An electrocardiogram showed acute inferior myocardial infarction and serial CPK enzyme levels peaked at 958 IU/L with 9% MB fraction. ...
Fowles R E - - 1995
Substantial advances in the diagnosis and treatment of ischemic heart disease, especially myocardial infarction, have reduced mortality rates during the past several years. This progress is tempered, however, by the continuing large overall incidence of myocardial infarction and cardiac death in persons in their prime years. Preventive measures are important ...
Morgan C D - - 1995
The efficacy, and mechanisms of benefit, of thrombolytic therapy in reducing mortality following myocardial infarction are time-dependent. Early treatment results in myocardial salvage and preservation of left ventricular function, mediated through prompt restoration of normal antegrade infarct artery perfusion. Later treatment exerts favourable effects on electrical stability of the myocardium ...
Pettersen K I - - 1995
Age-related use of fibrinolytic therapy in acute myocardial infarction was studied for patients admitted to the intensive care unit in four hospitals comprising 10% of the national hospital bed capacity in Norway. Altogether, 446 patients were included. All had validated acute myocardial infarction or acute ischaemic coronary heart disease treated ...
Hollander J E - - 1995
OBJECTIVE: To determine the safety of thrombolytic use in patients with cocaine-associated myocardial infarction. DESIGN: Retrospective cross-sectional survey. SETTING: Twenty-nine acute care institutions. PATIENTS: Patients who sustained cocaine-associated myocardial infarction from 1987 to 1993 were identified through medical record review. Those who received thrombolytic therapy (n = 25) were compared ...
Reeder G S GS Coronary Care Unit, Mayo Clinic Rochester, MN 55905, - - 1995
Adjunctive therapy for acute myocardial infarction should include aspirin, beta-adrenergic blocking agents, and, in most patients, consideration of the use of angiotensin-converting enzyme inhibitors, especially if left ventricular function is reduced. Heparin has an important adjunctive role in enhancing early vessel patency in patients who receive tissue-type plasminogen activator and ...
Behar S - - 1995
BACKGROUND: Since the introduction of thrombolytic therapy for patients with acute myocardial infarction, the use of coronary angiography has substantially increased. We sought to determine whether the presence of on-site coronary angiographic facilities influenced the utilization of coronary procedures in patients with acute myocardial infarction hospitalized in Israel's coronary care ...
Sloan M A - - 1995
Parenchymatous intracerebral hemorrhage (ICH) is a serious, infrequent complication of thrombolytic therapy for acute myocardial infarction. We studied the clinical and radiologic features, manner of presentation, associated factors, and temporal course in 23 patients with ICH associated with 150 mg or 100 mg recombinant tissue-type plasminogen activator (rt-PA) and heparin ...
Bleeker J K - - 1995
BACKGROUND: Early thrombolytic therapy for patients having a myocardial infarct size and improves survival. AIM: A study was undertaken to examine the components of pre-hospital delay in patients with retrospectively proven myocardial infarction. METHOD: Data were gathered from 300 patients with a documented myocardial infarction admitted to three hospitals in ...
Cairns J - - 1995
Thrombolytic therapy is a huge advance in the management of acute myocardial infarction (AMI). The results of large clinical trials over the past 9 years have unequivocally demonstrated its benefit: of every 1000 patients treated 30 will be saved, at a cost of two cases of nonfatal cerebral hemorrhage and ...
Jafri S M - - 1995
Thrombolytic therapy has been established as a safe and effective therapeutic strategy in acute myocardial infarction (MI). Its efficacy is improved with early administration, although modest benefits can be demonstrated for up to 12 hours. Tissue plasminogen activator (TPA) appears to offer benefits over streptokinase when administered to patients who ...
Blankenship J C - - 1995
PURPOSE: To determine whether subclinical cholesterol embolization is a frequent sequela of thrombolytic therapy. Case reports of catastrophic cholesterol embolization temporally associated with thrombolytic therapy in 19 patients have suggested a causal relationship. PATIENTS AND METHODS: We prospectively followed 60 patients with acute myocardial infarction who underwent coronary bypass surgery ...
French J K - - 1995
1. The aim of this study was to evaluate the utility of measurement of left ventricular function in assessing the efficacy of thrombolytic agents. 2. All published studies were reviewed. 3. The major effect of the introduction of thrombolytic therapy on mortality after myocardial infarction has been a dramatic decrease ...
Morgan B - - 1995
Thrombolytic therapy has emerged as the treatment of choice for patients presenting with an acute myocardial infarction. Myocardial infarction is a major cause of morbidity and mortality in the elderly. Advancing age has been considered a relative contraindication to thrombolytic therapy despite the potential for the elderly to derive the ...
Millaire A - - 1995
Anecdotal reports have suggested that cardiovascular complications may occur if thrombolytic therapy is performed in cases of pericarditis misdiagnosed as acute myocardial infarction. From 1980 to 1993, 47 cases of myopericarditis mimicking myocardial infarction have been admitted to our institution. The misdiagnosis was made because of clinical onset characterized by ...
Pettersen K I - - 1995
Intravenous thrombolytic therapy is known to reduce mortality in acute myocardial infarction. The effect is highly time dependent and is uncertain 12 hours or more after onset of major symptoms. In order to assess aspects of quality of care for the initial treatment of acute myocardial infarction, pre- and in-hospital ...
Plante Sylvain - - 1995
The use of thrombolytic agents in the context of an acute myocardial infarction has resulted in a significant decrease in postinfarction mortality. However, at this time, little information supporting the routine use of invasive diagnostic and therapeutic interventions in all patients with acute myocardial infarction having received thrombolytic agents is ...
Kennedy J. Ward - - 1995
There is growing interest in the use of angioplasty as the primary method to achieve coronary artery reperfusion in patients with acute myocardial infarction. The use of thrombolytic therapy has been established as effective in many large clinical trials, while only a few small studies have been completed comparing primary ...
Dracup K - - 1995
With the advent of thrombolytic therapy and other coronary reperfusion strategies, rapid identification and treatment of acute myocardial infarction greatly reduces mortality. Unfortunately, many patients delay seeking medical care and miss the benefits afforded by recent advances in treatment. Studies have shown that the median time from onset of symptoms ...
Bautista R E - - 1995
BACKGROUND: Dislodging of preexisting cardiac thrombi has been a reported but unconfirmed cause of embolic strokes after thrombolytic therapy for myocardial infarction. CASE DESCRIPTION: An 82-year-old woman was admitted with congestive heart failure. Initial echocardiogram demonstrated ventricular thrombi. Three days later she experienced an inferior wall myocardial infarction, and intravenous ...
Meyer Beat J. - - 1995
The major goal of myocardial reperfusion therapy is to restore normal coronary blood flow as quickly as possible and to maintain coronary patency in the highest number of patients with acute myocardial infarction. Recent studies support the hypothesis that more rapid and complete restoration of coronary flow through the infarct-related ...
Reiner Jonathan S. - - 1995
Over the last decade the use of thrombolytic therapy for patients with acute myocardial infarction has resulted in a substantial mortality reduction. While the utility of thrombolytic therapy is now widely recognized, the role of post-infarction coronary angiography remains controversial. In this report we examine the early studies which investigated ...
Altman R - - 1995
In this pilot study the combined use of desmopressin, which releases tissue plasminogen activator from vascular endothelium, and a low dose of streptokinase as a new thrombolytic regimen for acute myocardial infarction is proposed. Eighteen patients with acute myocardial infarction were treated intravenously with 150,000 U (4 patients) or 250,000 ...
Moliterno DJ - - 1995
The benefits of thrombolytic therapy in the treatment of acute myocardial infarction are incontrovertible. Large-scale studies combining angiographic and clinical end-points have demonstrated a perfusion-mortality relationship, with the highest survival rate among patients with early restoration of TIMI grade 3 coronary arterial flow. Despite advances in thrombolytic strategies, a substantial ...
Høst N B - - 1995
This paper assesses alterations in collagen metabolism following thrombolytic therapy of acute myocardial infarction with tissue-plasminogen activator. Sequential serum measurements of the amino-terminal propeptide of type III procollagen (S-PIIINP) and the carboxyterminal propeptide of type I collagen (S-PICP) in patients suspected of acute myocardial infarction randomized to tissue-plasminogen activator or ...
Feld S - - 1995
Myocardial necrosis progresses with the duration of coronary occlusion in the early stages of acute myocardial infarction. Prompt recanalization of the infarct-related artery resulting in effective and sustained reperfusion of jeopardized myocardium is the goal of modern therapy. Clinical thrombolysis trials have demonstrated a significant survival advantage for treated patients, ...
Michels R - - 1995
Background: Urokinase or two-chain urokinase-type plasminogen activator has been shown to be effective in the treatment of acute myocardial infarction. Its parent molecule, single-chain urokinase-type plasminogen activator (scu-PA), unlike urokinase, can selectively activate fibrin-bound plasminogen. The induced clot lysis is amplified by plasmin-triggered conversion of scu-PA to urokinase and by ...
Friedman B M - - 1995
The demonstration that the vast majority of acute transmural myocardial infarctions are caused by an occlusive thrombus in the coronary artery, together with the concept that myocardium can be salvaged for a period of time after the onset of such occlusion, has heralded a new era of management of this ...
Xue Q - - 1995
Analysis of high frequency (150-250 Hz) in the signal-averaged electrocardiogram (SAECG) is one of the emerging methods for detecting vessel patency in acute myocardial infarction following thrombolytic therapy and angioplasty. Root-mean-square voltage (RMSV) of the filtered QRS has been used in earlier studies to detect reperfusion; however, previous analysis indicated ...
Kido H - - 1995
An examination was made of the coronary thrombolytic effects of nasaruplase in a canine model of acute myocardial infarction. The model was produced by selective injection of an artificial thrombus into the coronary artery stenosed by laser ablation. Intravenous nasaruplase (8 U/kg/min) showed an equivalent thrombolytic effect to a recombinant ...
Granger C B - - 1994
Individual studies of patency rates and left ventricular (LV) function after thrombolysis have generally been limited by small numbers of observations, wide confidence intervals, and limited numbers of time points. To obtain a more reliable estimate of patterns of patency and LV ejection fraction, a systemic overview of angiographic studies ...
Figueredo V M - - 1994
Thrombolytic therapy markedly reduces mortality and improves left ventricular function in patients with acute myocardial infarction. Improvement may be even more substantial with adjuvant therapy. Aspirin has proved to be effective adjuvant therapy to thrombolysis. Other antiplatelet agents that may be even more effective or have an additive effect with ...
Cannon C P - - 1994
OBJECTIVES: The aim of our study was to determine a superior thrombolytic regimen from three: anistreplase (APSAC), front-loaded recombinant tissue-type plasminogen activator (rt-PA) or combination thrombolytic therapy. BACKGROUND: Although thrombolytic therapy has been shown to reduce mortality and morbidity after acute myocardial infarction, it has not been clear whether more ...
Morgan C D - - 1994
OBJECTIVES: To determine the influence of timing, infarct location and thrombolytic therapy on the electrocardiographic (ECG) response to exercise testing following acute myocardial infarction. DESIGN: Maximal treadmill exercise testing was performed on postinfarction day 8 and repeated on day 90 as part of a previously reported double-blind, placebo controlled study ...
Awadh N - - 1994
We report a case of 63-year-old man who developed massive pulmonary hemorrhage following intravenous streptokinase for acute myocardial infarction. Pulmonary hemorrhage was diagnosed by the triad of hemoptysis, a drop in hematocrit, and a new unilateral infiltrate on chest radiograph. This diagnosis was confirmed by autopsy findings. Pulmonary hemorrhage has ...
Fukunaga T - - 1994
To determine whether the severity of residual coronary artery stenosis immediately after thrombolytic therapy influences the size of later left ventricular (LV) asynergic area, we reviewed coronary angiograms (CAGs) and left ventriculograms (LVGs) of 31 patients with acute myocardial infarction (AMI). All patients received intracoronary urokinase therapy within 6 h ...
St Goar F G - - 1994
The management of acute myocardial infarction has evolved greatly with the development of interventional cardiology and thrombolytic therapy. Interventional strategies in the setting of thrombolytic therapy include immediate, delayed, and elective PTCA. Randomized trials suggest no benefit to these approaches; however, primary PTCA without adjunctive lytics when compared to lytic ...
Ayanian J Z - - 1994
BACKGROUND: The respective roles of generalist and specialist physicians in the care of patients is currently a matter of debate. Information is limited about the knowledge and practices of generalist and specialist physicians regarding conditions that both groups treat, such as myocardial infarction. METHODS: We therefore surveyed 1211 cardiologists, internists, ...
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