Search Results
Results 601 - 650 of 1096
< 8 9 10 11 12 13 14 15 16 17 18 >
White H - - 1993
A brief outline is presented of a proposed trial of Hirulog versus heparin after thrombolytic therapy with streptokinase (SK). The lower patency rates achieved with SK compared with tissue plasminogen activator (t-PA) suggest that a potent thrombin specific agent may be more important for SK than for t-PA therapy. This ...
Van de Werf F - - 1993
Recent angiographic studies after thrombolytic therapy have shown that the rates of effective coronary reperfusion (TIMI grade 3) is still quite low with currently available thrombolytic regimens. Approaches to improving thrombolytic efficacy include the development of mutants of t-PA, recombinant staphylokinase and conjugations of thrombolytic agents to monoclonal antibodies targeted ...
Bett J H - - 1993
Conflicting results on the benefit of thrombolytic therapy administered six to 24 hours after the onset of myocardial infarction (MI) led to the LATE trial. Five thousand seven hundred and eleven patients were treated with recombinant tissue plasminogen activator (t-PA) or placebo, treatment was begun between six and 24 hours ...
Gemmill J D - - 1993
OBJECTIVE: To assess the clinical ability of general practitioners to decide to give thrombolytic therapy to patients with suspected myocardial infarction and to assess the contribution of the electrocardiograph (ECG) to this decision-making process. SETTING: 7 practices on the North side of Glasgow and the coronary care unit of Stobhill ...
Kahn J K - - 1993
Multiple lifesaving options are currently available for treatment of acute myocardial infarction as a medical emergency. Serial electrocardiography and continuous ST-segment monitoring, urgent echocardiography, rapid enzyme analysis, and cardiac catheterization may all assist in the accurate and early diagnosis of acute myocardial infarction. Both intravenous thrombolytic therapy and direct infarct ...
Berger P B - - 1993
OBJECTIVES: The purpose of this study was to determine the incidence of ventricular tachycardia and fibrillation without hypotension or heart failure after treatment with recombinant tissue-type plasminogen activator (rt-PA), anatomic correlates of their development, the effect of immediate intravenous metoprolol on their occurrence and the outcome of patients with these ...
Ohman E M - - 1993
BACKGROUND: The use of thrombolytic therapy in myocardial infarction has been associated with a considerable improvement in survival rate; however, almost 40% of the deaths during hospitalization occur during the first 24 h. Clinical and angiographic characteristics identified through careful comparison of those patients who die early with those who ...
Melchior T - - 1993
Based on two case reports, problems of diagnosis and treatment of aortic dissection are discussed. Thrombolytic treatment given to patients with aortic dissection presenting symptoms mimicking acute MI seems to have a fatal outcome. Indications, as well as contra-indications, for thrombolytic therapy are therefore of great importance, when this treatment ...
Linderer T - - 1993
OBJECTIVES: The purpose of this study was to compare the effects of very early (< or = 1.5 h after symptom onset) and later (> 1.5 up to 4 h) thrombolytic therapy on infarct size, left ventricular function and early mortality in patients with acute myocardial infarction. To start thrombolysis ...
Kaufman H H - - 1993
The incidence of intracerebral hematomas after myocardial infarction increases after thrombolysis. As noted in the case described, clots formed after the administration of thrombolytic agents may remain liquid, and this blood can be drained by a catheter. However, in this case, the patient continued to bleed locally. This problem requires ...
Ketley D - - 1993
Little is known about incorporation of new knowledge from randomised clinical trials into clinical practice. Thrombolytic therapy was shown to reduce the mortality of acute myocardial infarction in several large trials published during 1986-88. To examine the effect of these data on clinical practice, we analysed the supply of thrombolytic ...
Dickstein K - - 1993
OBJECTIVES: The Nordic Enalapril Exercise Trial was a multicenter subtrial of the Cooperative New Scandinavian Enalapril Survival Study (CONSENSUS II) designed to evaluate the effect on maximal exercise performance of a 6-month period of enalapril treatment initiated early after myocardial infarction. BACKGROUND: When begun early after myocardial infarction, converting enzyme ...
Taylor H A - - 1993
BACKGROUND: To better understand the role of race/ethnicity in survival after acute myocardial infarction, we compared clinical and laboratory data, response to thrombolytic therapy, and clinical outcome in 2885 patients participating in the Thrombolysis in Myocardial Infarction Phase II (TIMI II) Trial among three groups of patients (2564 whites, 174 ...
Overgaard K - - 1993
The efficacy of delayed thrombolysis with recombinant tissue plasminogen activator was tested in combination with the ischaemic protecting drug NBQX in an embolic stroke model. In 113 rats the carotid territory was embolized with a fibrin-rich clot formed in polyethylene tube. Hemispheric cerebral blood flow (CBF) was measured by intra-arterial ...
Rawles J - - 1993
STUDY OBJECTIVES: (1) To measure the quality of life and the loss of quality adjusted days (QADS) after suspected acute myocardial infarction in patients who received thrombolytic treatment either at home or in hospital. (2) To compare the loss of QADS as a trial endpoint with the conventional endpoints of ...
Lechleitner P - - 1993
Plasma concentrations of polymorphonuclear granulocytes elastase (PMN elastase) in complex with alpha-1 proteinase inhibitor are a marker of neutrophil activation. The latter complex, creatine kinase and cardiac troponin T, were measured in peripheral venous blood samples serially drawn in 39 patients with acute myocardial infarction. Of the total, 29 received ...
Moliterno D J - - 1993
BACKGROUND: In the minutes to days after myocardial infarction, endogenous lysis of an occlusive coronary arterial thrombus occurs in most subjects. Compared with those in whom thrombolysis does not occur, those with antegrade flow in the infarct artery have improved left ventricular performance, less left ventricular dilatation, and improved survival. ...
O'Rourke R A - - 1993
The improved survival of patients with coronary heart disease during the past 30 years has resulted in a large elderly patient population who likely are at greater risk for developing cerebrovascular disease. In the 1960s, the total in-hospital mortality for patients with acute myocardial infarction under 70 years old was ...
Hermosillo A G - - 1993
OBJECTIVES: The purpose of this study was to determine whether infarct-related coronary artery patency influences myocardial electrical stability as measured by the prevalence of late potentials or heart rate variability. BACKGROUND: Several studies have suggested that loss of vagal activity is associated with an increased incidence of arrhythmic death after ...
Haq A - - 1993
The influence of tissue plasminogen activator (t-PA) and heparin versus heparin alone on anatomic characteristics of patent infarct-related coronary arteries and the development of these angiographic descriptors in coronary arteries that remain patent during the hospital course was examined in 108 patients who participated in a placebo-controlled trial of recombinant ...
- - 1993
BACKGROUND: The efficacy of thrombolytic therapy for acute myocardial infarction depends partly on how soon after the onset of symptoms it is administered. We therefore studied the efficacy and safety of thrombolytic therapy administered before hospital admission and thrombolytic therapy administered after admission in patients with suspected myocardial infarction. METHODS: ...
Young I S - - 1993
We have investigated the timescale of increased lipid peroxidation following successful early thrombolytic therapy for acute myocardial infarction and report for the first time reciprocal changes in plasma chain-breaking antioxidants. Sixty-seven patients were recruited following a first acute myocardial infarction within 6 h of the onset of symptoms and received ...
Birnbaum Y - - 1993
We describe a 45-year-old man who developed a spontaneous hemarthrosis of his right knee following thrombolytic therapy with streptokinase and rtPA for acute myocardial infarction. Surprisingly, despite the wide use of thrombolytic therapy, only four cases of spontaneous hemarthrosis following thrombolysis have been previously reported. Prompt aspiration of the joint, ...
Toupin L R - - 1993
Thrombolytic agents are routinely given to patients with acute myocardial infarction, often in combination with heparin. Genitourinary hemorrhage is an uncommon adverse effect of systemic thrombolysis, and acute azotemic complications are distinctly rare. We describe a case of genitourinary hemorrhage after combined thrombolytic and antithrombotic therapy leading to acute bilateral ...
Doggen C J - - 1993
AIMS: To examine changes in the medical management of acute myocardial infarction in the Auckland region between 1983 and 1990. METHODS: 6190 patients aged 25-64 years with myocardial infarction were identified utilising a population based register, the ARCOS study. Data were collected on resuscitation attempts, transportation to hospital, coronary care ...
Picard M H - - 1993
To investigate the influence of thrombolytic therapy on the natural history of left ventricular size and regional function after myocardial infarction, 32 patients treated with acute thrombolytic therapy (treatment group) were studied by echocardiography on admission to the hospital and at 1 week, 3 months, and 1 year after myocardial ...
Vermeer F - - 1993
Infarct size can be assessed in patients with myocardial infarction by calculating cumulative enzyme release. The two compartment model is used in patients who received thrombolytic therapy as well as in patients who were not treated with thrombolytic agents. The most practical approach is to calculate cumulative release of lactate ...
Belenkie I - - 1993
Early reperfusion during AMI results in myocardial salvage, recovery of function and reduced mortality (level I). This can be achieved with all of the currently available thrombolytic agents (level I). Benefits from late reperfusion are not proven but there are data which suggest that delayed reperfusion is better than persistent ...
Ellicott C - - 1993
We carried out a prospective survey of the outcome of patients with 'suspected myocardial infarction', in order to determine where they should be nursed. The delay between onset, admission, transfer to the CCU, the sequelae and side-effects of thrombolytic therapy were noted and were documented prospectively. Of 217 admissions to ...
Silber H - - 1993
The predictability of left ventricular function, short- and long-term prognosis, assessed by means of two easily obtainable noninvasive markers, was prospectively studied in 110 consecutive patients undergoing thrombolytic therapy for acute myocardial infarction. Positive noninvasive markers were defined as follows: a) > 50% reduction in ST segment elevation within 120 ...
Turi Z G - - 1993
Although the efficacy of recombinant tissue-type plasminogen activator (rt-PA) in acute myocardial infarction has been demonstrated, little formal dose-ranging information is available. This study examined the use of duteplase, the double-chain rt-PA subsequently used in the Third International Study of Infarct Survival, in a multicenter trial of 267 patients with ...
Seifried E - - 1993
In 12 patients treated with 100 mg rt-PA/3 h for acute myocardial infarction (AMI), serial fibrinogen levels were measured with the Clauss clotting rate assay ("functional fibrinogen") and with a new enzyme immunoassay for immunologically intact fibrinogen ("intact fibrinogen"). Levels of functional and "intact fibrinogen" were strikingly different: functional levels ...
Shammas N W - - 1993
The properties and physiological effects of three currently FDA-approved thrombolytic agents, streptokinase (SK), tissue plasminogen activator (tPA), and anisoylated plasminogen activator complex (APSAC) are reviewed. All thrombolytic agents have been shown to reduce mortality postmyocardial infarction (MI). Comparative trials have failed to demonstrate a difference between the effects of tPA, ...
Chapman G D - - 1993
Despite the proven benefits of thrombolytic therapy in acute myocardial infarction, concern for its complications, especially in patients misdiagnosed with myocardial infarction, has led to hesitancy in its use. Historical, clinical and electrocardiographic criteria were developed for enrolling patients with suspected acute myocardial infarction into thrombolytic trials by noncardiovascular specialists. ...
Gibbons R J - - 1993
BACKGROUND: Immediate angioplasty and the administration of a thrombolytic agent followed by conservative treatment are two approaches to the management of acute myocardial infarction, but these methods have not been compared prospectively. METHODS: We enrolled 108 patients with acute myocardial infarction in a randomized trial designed to test the hypothesis ...
Woo K S - - 1993
Thrombolytic therapy reduces early mortality, preserves left ventricular function and improves long term prognosis of acute myocardial infarction. However it is relatively expensive and increasing use will have considerable financial consequences. With competing demand for health resources, information on economic evaluation of this revolutionary therapeutic modality is much needed. Economic ...
Wall T C - - 1993
OBJECTIVES: The aim of this study was to assess the hemorrhagic risk associated with fibrin-specific thrombolytic therapy and invasive procedures with acute myocardial infarction. BACKGROUND: Successful coronary artery reperfusion has important prognostic implications. Because immediate coronary angiography is the only method proved to differentiate early fibrinolytic success from failure, its ...
Datar R V - - 1993
One link in the complex chain of medical economics is the cost of bringing new drugs and biologicals to the market. Advances in recombinant-DNA technology permit production of therapeutically active proteins in effectively unlimited quantities. Nevertheless, each expression system has a characteristic influence on the nature of the product produced ...
Becker R C - - 1993
BACKGROUND: Thrombolytic therapy is the treatment of choice for many patients with myocardial infarction, particularly those presenting to the hospital within 6 hours from symptom onset. Although prompt treatment promises to provide the greatest overall benefit, delayed thrombolysis (possibly beyond a time when myocardial salvage is achieved) may also have ...
Becker R C - - 1993
Although thrombolytic therapy has been shown to limit infarct size, preserve left ventricular function, and improve survival in most subgroups of patients with acute MI, a benefit has not been demonstrated in patients with clinical left ventricular dysfunction or overt cardiogenic shock before treatment is initiated. The reason(s) for the ...
Kalbfleisch J M - - 1993
Duteplase, 98% double-chain recombinant tissue-type plasminogen activator, was administered intravenously in 488 patients with acute myocardial infarction in a multicenter, open, safety and patency study. Duteplase dosing was based on body weight. Duteplase was administered as a bolus of 0.04 MIU/kg of thrombolytic activity followed by 0.36 MIU/kg over 1 ...
Odemuyiwa O - - 1993
Depressed baroreceptor sensitivity (BRS) has been associated with an increased risk of ventricular arrhythmias and sudden cardiac death after myocardial infarction, but the influence of thrombolytic therapy on BRS has not been examined. To determine the effect of thrombolytic therapy on the evolution of BRS after myocardial infarction, BRS was ...
Chouhan L - - 1993
There are differences in the risk factor profile and coronary anatomy of young patients who develop coronary artery disease compared with those of older ones. There is an absence of data in published reports regarding the response to thrombolytic therapy and the outcome of acute myocardial infarction in young patients. ...
Masuoka H - - 1993
We describe an autopsy case of severe intracranial hemorrhage which occurred during the infusion of tissue plasminogen activator (t-PA) for acute myocardial infarction. A 75-year-old man was admitted with substernal chest pain of 3-h duration and electrocardiographic changes consistent with an acute inferior myocardial infarction. Physical examination was unremarkable, except ...
Goto S - - 1993
The incidence of early reocclusion is reported to be higher in patients who receive fibrin-specific thrombolytic agents than nonspecific ones. The reason has yet to be clarified. In the present study, we focused on the difference in duration of fibrinolytic activity. The hemostatic parameters of 7 consecutive patients suffering from ...
Jugdutt B I - - 1993
OBJECTIVE: To review the evidence for the temporal pathophysiological evolution of structural, topographic and functional changes during remodelling post infarction, and how the timing and duration of therapeutic interventions for limiting remodelling might influence outcome. DATA SOURCES: Published English language literature. STUDY SELECTION: The focus was on experimental and clinical ...
Gardell S J - - 1993
Streptokinase, acylated plasminogen streptokinase complex, and tissue-type plasminogen activator (tPA) are widely used for the treatment of acute myocardial infarction. These thrombolytic agents restore blood flow in occluded coronary arteries, salvage myocardial function, and decrease mortality. The success of thrombolytic therapy depends on the prompt and stable recanalization of the ...
Becker R C - - 1993
It is widely accepted that coronary arterial patency, achieved early after symptom onset and maintained over time, is an absolute prerequisite for patient benefit following thrombolytic therapy. Conjunctive pharmacological agents such as heparin appear to play an important role in maintaining vessel patency, particularly following tissue plasminogen activator (t-PA) administration. ...
Kahn J K - - 1993
We report three cases of inadvertent thrombolytic administration to patients with cardiovascular diagnoses masquerading as acute coronary thrombosis presenting to tertiary care private hospital. Despite a final diagnosis of myocarditis, aortic dissection, and pericarditis, the initial presentation and electrocardiogram were believed to indicate an acute myocardial infarction due to coronary ...
Bleich S D - - 1993
The value of prompt coronary reperfusion utilizing thrombolytic therapy during acute myocardial infarction has been well established. However, new data indicates that although rapid reperfusion is imperative, this positive effect may, in fact, be partially or totally negated if patency is not sustained and complete. The following manuscript discusses the ...
< 8 9 10 11 12 13 14 15 16 17 18 >