Search Results
Results 551 - 600 of 1103
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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, ...
Buys E M - - 1994
We describe a case of spontaneous coronary artery dissection in a 38-year-old woman presenting with anterior myocardial infarction who was initially treated with thrombolysis. During the administration of thrombolytics the clinical symptoms and the electrocardiogram (ECG) deteriorated. Coronary angiography revealed a major dissection in the proximal left descending coronary artery. ...
Nicolini F A - - 1994
Nitroglycerin given with tissue-type plasminogen activator (t-PA) has been shown to decrease the thrombolytic effect of t-PA in animal models of coronary artery thrombosis. The present study was conducted to determine whether such an interaction between nitroglycerin and t-PA occurs in patients with acute myocardial infarction undergoing thrombolytic treatment. Patients ...
Rogers W J - - 1994
BACKGROUND: Multiple clinical trials have provided guidelines for the treatment of myocardial infarction, but there is little documentation as to how consistently their recommendations are being implemented in clinical practice. METHODS AND RESULTS: Demographic, procedural, and outcome data from patients with acute myocardial infarction were collected at 1073 US hospitals ...
Bode C - - 1994
Thrombolytic therapy is the established treatment of choice for most eligible patients with acute myocardial infarction. Early initiation of treatment and early, complete and maintained patency of the infarct-related coronary artery are desirable, because these variables correlate with a reduction in mortality. As a consequence, considerable efforts have been undertaken ...
- - 1994
Thrombolytic therapy reduces mortality from acute myocardial infarction. Moreover the earlier thrombolytic therapy is given after the development of infarction the greater the benefit. It is usual to start thrombolysis only after the patient has been admitted to hospital. In this article we discuss whether thrombolytic therapy should be started ...
Clarke K W - - 1994
OBJECTIVE: To determine whether women with acute myocardial infarction in the Nottingham health district receive the same therapeutic interventions as their male counterparts. DESIGN: Retrospective study. SETTING: University and City Hospitals, Nottingham. PATIENTS: All patients admitted with a suspected myocardial infarction during 1989 and 1990. MAIN OUTCOME MEASURES: Route and ...
Grignani G - - 1994
Thrombolytic therapy has become standard care in treating acute myocardial infarction. Fibrinolytic drugs such as streptokinase, APSAC and urokinase are non fibrin specific, and induce systemic activation of the fibrinolytic process, while t-PA and prourokinase are fibrin specific since they are able to activate mainly fibrin bound plasminogen. Both groups ...
Puletti M - - 1994
The incidence of hypotension in patients treated with thrombolytic agents for myocardial infarction was investigated in a series of 71 patients, 17 treated with urokinase, 35 with rtPA and 19 with APSAC. Hypotension was observed in 23.5% of the first group, in 5.5% of the second, and in 42.10% of ...
Walamies M - - 1994
The decrease in mortality among patients receiving thrombolytic therapy for myocardial infarction is greater than would be expected from the improvement in left ventricular contractile function alone; thus some additional advantage of recanalization of the infarct-related coronary artery probably exists. Changes in the post-infarction myocardial metabolic state with respect to ...
Gibbons R J - - 1994
OBJECTIVES: The purpose of this study was to estimate the effect of an improved reperfusion therapy for acute myocardial infarction on myocardial salvage and ventricular function for anterior and inferior infarctions and to ascertain the sample size required to detect such an effect. BACKGROUND: There are significant differences in myocardium ...
Grines C L - - 1994
During the past few decades, management of patients with myocardial infarction has dramatically evolved. High-risk patients are now identified by a variety of noninvasive tests, and aggressive use of reperfusion strategies has improved clinical outcomes. Despite the benefits of reperfusion, only a few patients are eligible to receive thrombolytic therapy. ...
Chandler W L - - 1994
The aims of this study were to determine whether elevated plasminogen activator inhibitor type 1 (PAI-1) activity after myocardial infarction reflects baseline PAI-1 or represents an acute-phase response secondary to the infarction, and to determine how tissue plasminogen activator (t-PA) activity and total t-PA antigen levels in healthy control subjects ...
Turnbull R G - - 1994
Atheroembolism after thrombolytic therapy, although rare, is unpredictable and carries a poor prognosis. Early diagnosis is difficult because of the many forms of presentation. A 76-year-old man with no history of atheromatous disease, who had received streptokinase as treatment for myocardial infarction, had lower gastrointestinal bleeding, progressive renal failure and ...
Zehender M - - 1994
OBJECTIVES: This study was undertaken to determine eligibility for and benefit of thrombolytic therapy in patients with acute inferior myocardial infarction with or without right ventricular involvement. BACKGROUND: Right ventricular involvement commonly complicates acute inferior myocardial infarction and is considered to have prognostic relevance. We hypothesized that the presence of ...
Fendrick A M - - 1994
BACKGROUND: To quantify population health consequences of increased use of thrombolytic therapy for acute myocardial infarction in the United States. METHODS: A decision analytic model was constructed to evaluate treatment-related outcomes for two myocardial infarction treatment strategies: standard therapy and standard therapy plus combination aspirin-thrombolytic therapy. Patients were entered into ...
Böttiger B W - - 1994
Thrombolytic therapy has proved to be efficacious in the treatment of massive and fulminant pulmonary embolism (PE), but thrombolysis has been considered as contraindicated during cardiopulmonary resuscitation (CPR). This review on the administration of thrombolytic agents in patients who have suffered massive PE necessitating CPR summarises 14 anecdotal reports and ...
Woo K S - - 1994
Thrombolytic therapy has revolutionized the treatment of acute myocardial infarction by reducing mortality and preserving left ventricular function. It is relatively safe and cost-effective. However, it is currently underused in most countries. Patients in whom thrombolysis is indicated include those with ST elevation on the electrocardiogram or bundle branch block ...
Wright R A - - 1994
OBJECTIVES: This study investigated the effects of captopril therapy on endogenous fibrinolysis in men with recent, uncomplicated myocardial infarction. BACKGROUND: Angiotensin-converting enzyme inhibitors reduce the incidence of acute coronary syndromes in patients with mild left ventricular dysfunction after myocardial infarction. Abnormal endogenous fibrinolysis, reflected in increased levels of endogenous tissue-type ...
Aguirre F V - - 1994
BACKGROUND: Few thrombolytic studies have assessed whether patient age is an indication for routine postlytic cardiac catheterization and revascularization or evaluated the impact of age on 1-year outcome differences after acute myocardial infarction. METHODS AND RESULTS: A secondary analysis of 3339 patients enrolled in the TIMI II trial was performed ...
Farrell A - - 1994
We developed an in situ perfused turtle (Chrysemys scripta) heart preparation to study its intrinsic mechanical properties at 5&deg;C and 15&deg;C using normoxic and anoxic perfusion conditions. The in situ preparation proved durable and stable. At 15&deg;C and a spontaneous heart rate of 23.4 beats min-1, maximum stroke volume was ...
Burnside J - - 1994
Thrombolytic therapy for myocardial infarction may contribute to bleeding complications when central venous or arterial access is required, but peripheral venous access is usually uncomplicated. We report a patient in whom tissue plasminogen activator and subsequent intravenous heparin exacerbated bleeding from a disrupted intravenous access site, leading to acute compartment ...
Salvioni A - - 1994
The purpose of this study was to investigate whether, to what extent, and through which mechanisms intravenous heparin, administered before and after streptokinase, affects the plasma levels of D-dimer and fibrinogen in myocardial infarction. Data concerning mortality and incidence of coronary recanalization in patients receiving heparin and thrombolytic therapy after ...
Bell W R - - 1994
The patient must be educated to seek medical attention promptly when this malady strikes, and the physician must likewise be taught to institute this therapy as soon as the patient is seen. Less than 6 years ago, it was strongly expressed that there was no rationale for attempting to restore ...
Aversano T - - 1994
The hypothesis that an increase in the amplitude (root-mean-square voltage) of the high frequency (150-250 Hz) components of the QRS complex occurs with successful reperfusion following thrombolytic therapy in acute myocardial infarction (AMI) and fails to occur when thrombolysis fails was tested. Clinical markers for successful or failed reperfusion following ...
- - 1994
BACKGROUND: Although coronary thrombosis plays a critical role in the pathogenesis of unstable angina and non-Q-wave myocardial infarction (NQMI), the effects of thrombolytic therapy in these disorders is not clear. Also, the role of routine early coronary arteriography followed by revascularization has not been established. METHODS AND RESULTS: Patients (n ...
Pashos C L - - 1994
OBJECTIVES: In this study, we investigated the use of thrombolytic agents and other cardiac drugs in a national cohort of patients with acute myocardial infarction and assessed the influence of large clinical studies on types of thrombolytic therapy prescribed. BACKGROUND: Information about usage patterns for these drugs is unavailable, and ...
O'Rourke R A - - 1994
On the basis of the available data concerning the indications for and the timing of arteriography after thrombolysis, the inevitable conclusion is that conservative instead of aggressive management is indicated for the 40% to 50% of patients at low risk who do not have spontaneous myocardial ischemia or myocardial ischemia ...
Kleiman N S - - 1994
Fifteen patients who arrived between 6 and 24 hours after the onset of acute myocardial infarction and who were found to have totally occluded coronary arteries, received aspirin, heparin, and tissue plasminogen activator given over 3 hours. Eight patients were randomly assigned to receive intravenous prostaglandin E1, 20 ng/kg/min for ...
Simari R D RD Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic Rochester, Minnesota - - 1994
To address the current clinical applications, outcomes, and limitations of coronary angioplasty in the setting of acute myocardial infarction. We review the results of several large trials in which various strategies of thrombolysis and primary, immediate adjunctive, rescue, or deferred adjunctive coronary angioplasty were used in patients with acute myocardial ...
Weston C F - - 1994
In light of recent publications relating to resuscitation and pre-hospital treatment of patients suffering acute myocardial infarction of British Heart Foundation convened a working group to prepare guidelines outlining the responsibilities of general practitioners, ambulance services, and admitting hospitals. The guidelines emphasise the importance of the rapid provision of basic ...
Harrington R A - - 1994
OBJECTIVES: The purpose of this study was to examine the incidence and clinical implications of thrombocytopenia that occurs in hospital after administration of thrombolytic therapy for acute myocardial infarction. BACKGROUND: The use of thrombolytic therapy in patients with acute myocardial infarction has improved mortaltiy rates, but hemorrhage remains a major ...
Karalis D G - - 1994
Arterial embolization from thrombolytic therapy for acute myocardial infarction is rare. We report two cases of spontaneous arterial embolization following the use of tissue plasminogen activator for acute myocardial infarction. Transesophageal echocardiography was able to identify the source of embolism as mobile atherosclerotic debris within the thoracic aorta. This information ...
Handlin L R - - 1994
Both direct angioplasty and thrombolytic therapy can decrease mortality from acute myocardial infarction, but certain subgroups of patients benefit more from one method than the other. Direct angioplasty is favored in patients in cardiogenic shock (with perhaps the exception of those who are elderly or have three-vessel coronary disease) and ...
Behar S - - 1994
A national study was performed in early 1992 in the 25 operating coronary care units in Israel, which enabled the assessment of whether the therapeutic management of patients with acute myocardial infarction was affected by patient gender. During a 2-month period, 1,014 consecutive patients with acute myocardial infarction were hospitalized. ...
Handlin L R - - 1994
There is little question that reperfusion therapy with thrombolytic agents benefits patients who meet the current eligibility requirements and receive therapy shortly after acute myocardial infarction. Less clear is whether this therapy would benefit and be safe for use in patients who are now deemed ineligible to receive it. The ...
Brügemann, Johannes
Insight in the mechanisms leading to acute myocardial infarction (MI) has resulted in the administration of exogenous plasminogen activator, later called thrombolytic therapy. This treatment was associated with a significant reduction in mortality and morbidity. However, success has not always been achieved due to failure to achieve reperfusion or occurrence ...
Hugenholtz P G - - 1994
Proper understanding of the pathological process of a ruptured plaque followed by thrombus formation remains the basis for rational therapy of cardiac ischaemia and myocardial infarction. With the advent of better thrombolytic regimens, improved direct reperfusion via angioplasty and streamlined recognition/admission procedures, therapeutic strategies for dealing with acute myocardial infarction ...
Merriman C S - - 1994
Thrombolytic therapy was administered to a 64-year-old man with an acute anterolateral myocardial infarction who had received cardiopulmonary resuscitation (CPR) for 24 minutes. At the time of thrombolytic therapy, the patient was alert and without clinical or radiographic evidence of injury. The patient developed a retroperitoneal hematoma related to femoral ...
Rozenman Y - - 1994
Myocardial damage in acute myocardial infarction is a time-dependent process. Thrombolytic therapy effectively opens the coronary artery, restores coronary blood flow and prevents ongoing necrosis. We examined the effect of very early thrombolytic therapy (including prehospital administration) in a consecutive group of 510 patients with myocardial infarction on the following ...
Høst N B - - 1994
The objective of the study was to monitor collagen metabolism after thrombolytic therapy. Sequential measurements of serum aminoterminal type-III procollagen propeptide (S-PIIINP) and carboxyterminal type-I procollagen propeptide (S-PICP) were made in 62 patients suspected of acute myocardial infarction and receiving thrombolytic therapy. Regardless of whether acute myocardial infarction was confirmed ...
Goyal S P - - 1994
Sixty five cases of Acute Myocardial Infarction, of which 40 cases received thrombolytic therapy, were followed up for a period of one year for clinical course and left ventricular function. Reperfusion was achieved in 65% cases who received thrombolytic therapy. At discharge and at one year treated group fared well ...
Overgaard K - - 1994
The effect of thrombolytic therapy is well-documented in acute myocardial infarction. In acute cerebral infarction, thrombolytic therapy has been evaluated in small series of patients. The point of thrombolytic therapy is to avoid or reduce ischemic damage of neuronal tissue by rapid arterial recanalization. In thrombolytic therapy of cerebral vascular ...
Mickley H - - 1994
In patients with acute myocardial infarction a substantial reduction in mortality can be achieved by early intravenous thrombolytic therapy. The beneficial effect of thrombolysis on left ventricular function is relatively small, and it seems unlikely that this minor improvement alone can be responsible for the reduction in cardiac death. So ...
White H D - - 1994
BACKGROUND: After thrombolytic therapy, long-term patency of the infarct-related artery may reduce arrhythmias, limit ventricular dilatation, and provide collaterals to another infarct zone if further infarction occurs. However, independent long-term prognostic value of infarct artery patency has not been shown. METHODS AND RESULTS: We followed 312 patients with first myocardial ...
von Hodenberg E - - 1994
Lipoprotein(a) (Lp(a)) and plasminogen share a high degree of structural homology. Therefore it has been suggested that elevated levels of Lp(a) may inhibit the profibrinolytic activity at the cell surface and increase the risk of thrombosis by competitive inhibition of plasminogen. In the present study we evaluated whether high levels ...
Haastrup B - - 1994
In order to describe the execution of thrombolytic therapy in acute myocardial infarction (AMI) in a coronary care unit, case records of 427 admissions in 1992 due to definite or possible AMI were reviewed: 32% received thrombolytic therapy while 68% did not because of contraindications, delayed admission, advanced age or ...
Dellborg M - - 1994
Beta-blockers, nitrates, aspirin and thrombolytic drugs have each separately been shown to reduce mortality in acute myocardial infarction, but the effect of these treatments combined during routine coronary care has not been assessed. The coronary care unit at Ostra Hospital services a stable community of 250,000 inhabitants. Since 1984 all ...
Cannon CP - - 1994
Thrombolytic therapy has dramatically reduced mortality following acute myocardial infarction (MI) with the major effect coming from early achievement of infarct-related artery patency. A major factor in achieving rapid reperfusion is early treatment with thrombolytic therapy. Recent trials have shown that mortality can be reduced if time to treatment is ...
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