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Qureshi Adnan I - - 2002
The field of intravenous and intra-arterial thrombolysis for the treatment of acute ischemic stroke is rapidly advancing. Limitations of existing thrombolytic agents have prompted the development of new thrombolytic agents over the last decade. These new agents are broadly classified as third generation thrombolytics. Two of the several third generation ...
Wilkinson J - - 2002
Shortening prehospital delay has been identified as an important means of improving responses to reperfusion treatment. If this increases the risk profile of the population delivered to hospital, it may paradoxically cause a deterioration in hospital mortality. To examine the interaction between arrival time (time from onset of chest pain ...
Orozović Vjekoslav - - 2002
BACKGROUND: Acute myocardial infarction of the right ventricle (AMI-RV) is a separate subgroup within the scope of inferoposterior infarction of the left ventricle. It still represents the population of patients at high risk due to numerous, often hardly predictable complications and high mortality rate. METHODS: In fifteen-year period (1987-2001) 3,765 ...
Daffertshofer Michael - - 2002
Re-opening of the occluded artery is the primary therapeutic goal in hyper-acute ischemic stroke. Systemic treatment with IV rt-PA has been shown to be beneficial at least in a 3 h 'door to needle' window and is approved within that interval in many countries. Trials of thrombolytic therapy with rt-PA ...
de Zwaan C - - 2002
AIMS: Complement inhibition by C1-inhibitor has been shown to reduce myocardial ischaemia-reperfusion injury in animal models. We therefore studied the effects of intravenous C1-inhibitor, following reperfusion therapy, in patients with acute myocardial infarction. METHODS AND RESULTS: C1-inhibitor therapy was started not earlier than 6h after acute myocardial infarction, in order ...
Baker William F WF - - 2002
The therapeutic use of thrombolytic agents is the natural result of the increasing understanding of the pathophysiologic mechanisms underlying normal and deranged thrombosis and fibrinolysis. Plasminogen activators capable of increasing the production of plasmin exhibit considerable efficacy in the treatment of a variety of arterial and venous thrombotic disorders. The ...
Witherow Fraser N - - 2002
OBJECTIVES: The aim of the present study was to assess the contribution of angiotensin-converting enzyme (ACE) inhibitor therapy to bradykinin-induced tissue-type plasminogen activator (t-PA) release in patients with heart failure (HF) secondary to ischemic heart disease. BACKGROUND: Bradykinin is a potent endothelial cell stimulant that causes vasodilatation and t-PA release. ...
Mountain David - - 2002
OBJECTIVE: To describe revascularization practice for acute myocardial infarction in a sample of Australasian hospitals during 1999. DESIGN: Survey for the 1999 calendar year. SETTING: Hospitals with Australasian College for Emergency Medicine-accredited emergency departments in Australia and New Zealand. PARTICIPANTS: Forty-eight hospitals of 80 surveyed (60%), comprising 15 tertiary and ...
Ali Omar - - 2002
BACKGROUND: Relatively limited information is available about recent, and trends over time, use of thrombolytic therapy in patients of different ages hospitalized with acute myocardial infarction and the association between use of thrombolytic therapy and hospital outcomes. METHODS: We conducted an observational study of 5601 residents of the Worcester, Massachusetts, ...
Marder Victor J - - 2002
Plasminogen activators (PA) are unique agents that are currently applied as thrombolytic therapy to achieve rapid vascular reperfusion. Regimens of PA plus anticoagulants and antiplatelet drugs have attained a high degree of sophistication and predictable rates of positive clinical outcomes for acute myocardial infarction (MI), ischemic stroke, pulmonary embolism (PE), ...
Rhydwen G R - - 2002
BACKGROUND: Post-myocardial infarction ventricular septal defect (VSD) complicates approximately 2% of myocardial infarctions. Thrombolytic therapy may accelerate the time from myocardial infarction to VSD formation. The effects of thrombolytic therapy in patients with a post-myocardial infarction VSD were investigated. METHOD: Demographic, procedural, and event data were retrospectively analysed in patients ...
Baker J W - - 2002
Haemorrhagic complications of thrombolytic therapy for myocardial infarction are common. A 68 year old man presented with a myocardial infarction and was started on tissue plasminogen activator. Soon after he experienced rectal bleeding and a barium enema showed a small carcinoma in the colon, which was treated surgically. It is ...
Yilmaz Mehmet Birhan - - 2002
There is no doubt that appropriate use of thrombolytic drugs improves survival in patients with acute myocardial infarction. Streptokinase, one of the most commonly used thrombolytic drugs in large clinical trials, is not fibrin-specific and brings about a lytic state with potential for bleeding. We report a case of spontaneous ...
Gill Sabine - - 2002
BACKGROUND: Thrombolytic therapy results in reperfusion of the occluded coronary vessel in approximately 75% of treated patients with acute myocardial infarction (AMI). Unsuccessful thrombolysis results in impaired outcome. This study was undertaken to evaluate reperfusion assessments with 12-lead standard static electrocardiography (ECG) and continuous vectorcardiography (VCG) in AMI patients treated ...
Pitt K - - 2002
OBJECTIVE: Heart disease is the major cause of death in Wales. Myocardial infarction accounts for most fatalities either acutely or as a result of late heart failure and unheralded sudden cardiac death. Prompt relief of new coronary occlusions by thrombolytic agents has been shown to reduce significantly both early mortality ...
Szabo Sebastian - - 2002
OBJECTIVES: Thrombolytic therapy in patients with acute myocardial infarction is hampered by bleeding complications and procoagulant effects favoring early reocclusion. TNK-tPA was shown in vitro to have considerable fibrin specificity. We investigated the effects of tenecteplase (TNK-tPA) and alteplase (rt-PA) on the haemostasis and fibrinolytic system. METHODS AND RESULTS: We ...
Stryer Daniel B - - 2002
The diagnosis and management of acute myocardial infarction and unstable angina pectoris are frequent challenges for emergency department staff. Strategies must quickly and accurately identify all patients requiring admission, monitoring, and reperfusion therapy to maximize outcomes without overdiagnosing. The Acute Cardiac Ischemia Time-Insensitive Predictive Instrument and the Thrombolytic Predictive Instrument ...
Kercher Kent W - - 2002
Portal vein thrombosis is a relatively rare clinical entity that can result in substantial morbidity and mortality. Because of the risk of intestinal infarction, acute symptomatic portal vein thrombosis requires prompt intervention. Traditional treatment has included anticoagulation and/or systemic thrombolytic therapy. We report the successful management of acute portal vein ...
Ben-Ami R - - 2002
Red blood cell (RBC) aggregation may contribute to occlusion of the coronary microcirculation during myocardial infarction. We studied the effect of thrombolytic therapy on RBC aggregation in patients with acute myocardial infarction (AMI). Compared with patients with myocardial infarction who did not receive thrombolytic therapy, those treated with systemic thrombolysis ...
Wang Yanni - - 2002
OBJECTIVE: To examine the procoagulant effects of thrombolytic agent on hemostasis and study the role of hemostatic markers as predictors of clinical outcomes. METHODS: In the present study, eighteen patients with acute myocardial infarction (AMI) received 1.5 or 2.0 million U nonspecific urokinase (UK), or 70 approximately 80 mg fibrin-specific ...
Chang Michael Chich-kuang - - 2002
We report an unusual case of cerebral embolization that occurred after intravenous thrombolytic therapy for myocardial infarction. Direct observation by serial echocardiograms in this patient confirmed that the thrombolytic treatment induced lysis and fragmentation of thrombus, and the subsequent dislodging and embolization of preexisting cardiac thrombi, which caused the cerebral ...
Vivekananthan Deepak P - - 2002
Numerous randomized trials have unequivocally shown that fibrinolytic therapy in the treatment of ST-segment elevation myocardial infarction substantially reduces mortality when administered within 12 hours of symptom-onset. Although fibrinolytic therapy initially restores antegrade flow in the infarct vessel in the majority of patients, sustained tissue-level reperfusion occurs in only approximately ...
Ryan Thomas J - - 2002
The recently published American College of Cardiology/American Heart Association Guidelines for the Management of Patients with Acute Myocardial Infarction stress 3 major points: (1) the prehospital phase from the onset of symptoms to definitive therapy in the emergency department must be shortened by 50% in order to reduce further the ...
Motovska Z - - 2002
Intravenous thrombolysis is the most accessible and the most common form of reperfusion therapy. The aim of this study was to identify demographic, clinical and electrocardiographic factors, which based on published data and in patients included in the project Audit of diagnostic and therapeutic procedures in patients with acute myocardial ...
Inoue Takehiro - - 2002
The management of patients with acute pulmonary embolism (PE) remains controversial, despite an improved understanding of its pathogenesis and diagnosis. Haemodynamic instability due to right ventricular failure and hypoxia following PE is associated with a high mortality rate. This report describes a case of a 22-year-old woman with leukaemia in ...
Petersen Laura A - - 2002
OBJECTIVES: The goal of this study was to assess racial differences in process of care and outcome for acute myocardial infarction in the VA health care system. DESIGN: Retrospective cohort study using clinical data. SETTING: Eighty-one acute care VA hospitals. PATIENTS: Four thousand seven hundred sixty veterans discharged with a ...
Aronow Wilbert S - - 2002
Patients aged 75 years and older comprise 36% of all patients with myocardial infarction and 60% of all deaths from myocardial infarction in the US. Data from randomised, placebo-controlled clinical trials and observational data demonstrated a beneficial effect of thrombolytic therapy in eligible patients with acute myocardial infarction younger than ...
Schreiber W - - 2002
OBJECTIVE: the aim of the study is to investigate the effect of thrombolytic therapy on neurological outcome in patients after cardiac arrest due to acute myocardial infarction. Laboratory investigations have demonstrated that thrombolytic therapy after cardiopulmonary resuscitation improves neurological function. METHODS: from July 1991 to June 1996, patients with witnessed ...
Mehta Nirav J - - 2002
We present a brief summary of the 10 greatest cardiologic developments and discoveries of the 20th century Described are electrocardiography; preventive cardiology and the Framingham Study; "lipid hypotheses" and atherosclerosis; coronary care units; echocardiography; thrombolytic therapy; cardiac catheterization and coronary angiography; open-heart surgery; automatic implantable cardiac defibrillators; and coronary angioplasty. ...
Zaidat O O - - 2001
Extra-cranial arterial dissection accounts for 10% of strokes in young people. Information on safety of thrombolytic administration in this group is limited. The literature, however, does not favor use of thrombolytics for myocardial ischemia when peripheral arterial dissection coexists. Based on the clinical and radiological features, two patients who presented ...
Hunter A J - - 2001
The use of thrombolytics in the management of acute myocardial infarction in eligible patients is the accepted standard of practice. We present the case of an embolic myocardial infarction in the setting of acute infectious endocarditis, treated with thrombolytics, resulting in a massive intracerebral hemorrhage and the patient's death. Historical ...
Chen S - - 2001
OBJECTIVE: To investigate the influence and mechanism of incidence of atrioventricular block (AVB) treated with thrombolytic therapy in acute inferior myocardial infarction (AIMI). METHODS: A total of 46 patients with AIMI were divided into the thrombolytic group (n = 23) and the non-thrombolytic group (n = 23). Intravenous or intracoronary ...
Tikiz H - - 2001
BACKGROUND: Although there is increasing evidence for the beneficial effect of thrombolytic therapy on global left ventricular (LV) function in acute myocardial infarction (AMI), the data concerning the early effect of thrombolytic therapy on the incidence of left ventricular aneurysm (LVA) formation and its relationship to clinical and angiographic determinants ...
M GARAK YARAGHI; Internal ...
Introduction. Although common theraputic methods for myocardial infarction are conducted, mortality and morbidity of this disease are high, yet. Therefore, finding a new economical therapies such as metabolic modulation of ischemic myocardial muscle with thrombolytic therapy can somehow improves this situation. This study investigates the effect of glucose, insulin, potassium ...
Sadanandan S - - 2001
BACKGROUND: Early reperfusion after myocardial infarction has been proved to preserve left ventricular function and reduce mortality. However, a significant number of patients have persistent occlusion of the infarct-related artery late (days to weeks) after myocardial infarction because of ineligibility for thrombolytic therapy, failure of reperfusion, or reocclusion. METHODS: In ...
Oomman A - - 2001
Primary angioplasty (PTCA) in acute myocardial infarction has many theoretical advantages including better antegrade flow and reduced intracranial haemorrhage. However the improvement in the mortality and morbidity of primary angioplasty in the randomized trials from sophisticated centres has not been translated to the community setting. Primary PTCA is a suitable ...
Huber K - - 2001
Disclosure of a specific prothrombotic/antifibrinolytic state by determination of plasminogen activator inhibitor type 1 (PAI-1), tissue-type plasminogen activator (t-PA), and t-PA/PAI-1 complex levels in plasma may help to define patients at high risk of developing acute coronary syndromes. According to the mechanisms of PAI-1 up-regulation, i.e. genetic factors, an activated ...
Duchateau F X - - 2001
Out-of-hospital thrombolytic therapy was administrated to a 53-year-old woman with confirmed acute myocardial infarction and refractory cardiac arrest. Standard advanced cardiac life support measures were performed by an out-of-hospital critical care team but they were unsuccessful. Thrombolytic therapy was given as a rescue therapy after prolonged cardiopulmonary resuscitation. The patient ...
Sugawara Y - - 2001
Intraarterial thrombolytic therapy has been used recently for treatment of acute ischemic stroke within 6 h after onset. Although hypoactivity of 99mTc-hexamethylpropyleneamine oxime (HMPAO) in stroke has been well documented, hyperactivity of HMPAO has not been evaluated in sufficient detail. The purpose of this study was to evaluate the incidence ...
Ross A M - - 2001
BACKGROUND: Reports from Japan suggest effective myocardial infarction (MI) treatment in Asian patients with much lower doses of tissue plasminogen activators (tPA) than used in European and American regimens. Because increasing doses of fibrinolytics lead to increased bleeding complications, identification of patients who respond to reduced doses is of importance. ...
Smith K J - - 2001
Early recognition and treatment of acute myocardial infarctions have been accepted as improving patient mortality. With the popular use of thrombolytic therapy, it is necessary to rule out contraindications and to consider other causes for ST segment elevation. A unique patient experiencing chest pain with marked and localized ST segment ...
Goldstein L B - - 2001
Over the past decade, there has been an explosion in data related to the treatment of patients with acute ischemic stroke. Thrombolytic therapy with intravenous tissue plasminogen activator has revolutionized the approach to stroke treatment. Intra-arterial administration of thrombolytic agents is also being investigated and is now being used on ...
Patel R J - - 2001
Although widely used in Europe, the prehospital 12-lead electrocardiogram (EKG) has seen only limited use in this country. Reported benefits of the 12-lead EKG include shortening the door-to-needle time, accelerating the initiation of reperfusion therapy, and overall improving the prehospital and hospital management and outcome of patients with acute myocardial ...
Davydov L - - 2001
BACKGROUND: Certain shortcomings of the available thrombolytic agents have prompted the search for a more fibrin specific fibrinolytic agent with a longer half-life. Such properties would allow bolus administration, possibly leading to faster reperfusion of occluded arteries. OBJECTIVE: This article focuses on the new thrombolytic agent tenecteplase, reviewing its mechanism ...
Voipio V - - 2001
OBJECTIVE: To investigate the safety and efficacy of thrombolytic treatment for an acute myocardial infarction (AMI) immediately after resuscitation in the out-of-hospital setting. DESIGN: Retrospective. SETTING: A middle-sized urban city (population 540000) served by a single emergency medical system using a tiered response with physicians in field. PATIENTS AND METHODS: ...
Modi K A - - 2001
Advances have occurred rapidly in how the patient who presents with acute ST elevation myocardial infarction is managed. Nevertheless, due to availability and effectiveness, medical therapy continues to be the mainstay of treatment. Several drugs are of proven efficacy in decreasing myocardial loss and mortality. Thrombolytics, antiplatelets, and anticoagulants combine ...
Böttiger B W - - 2001
Thrombolysis is an effective causal therapy for patients suffering from massive pulmonary embolism or acute myocardial infarction. In more than 70% of patients with cardiac arrest, one of these two diseases is the underlying cause of deterioration. Nevertheless, because of the fear of severe bleeding complications, thrombolytic therapy during cardiopulmonary ...
Spinler S A - - 2001
Therapy for acute myocardial infarction involves rapid restoration of blood flow through a coronary artery that has been occluded by a ruptured atherosclerotic plaque. Thrombolytic therapy, the pharmacologic standard to achieve this outcome, significantly improves survival; however, current regimens have limitations: they can fail to achieve complete reperfusion, they can ...
Gibson C M - - 2001
Use of abciximab in combination with administration of thrombolytics has been shown to improve epicardial and microvascular coronary blood flow in acute myocardial infarction (AMI). As a potential mechanism, we hypothesized that combination therapy would reduce angiographically evident thrombus (AET) and would increase lumen diameter compared with thrombolytic monotherapy. Patients ...
Huber K - - 2001
Rapid and sustained reperfusion of an occluded coronary artery is the goal of thrombolytic therapy in acute myocardial infarction. However, the clot-dissolving efficacy of fibrinolytic agents such as tissue-type plasminogen activator (t-PA) is limited, in vivo, in part by the action of plasminogen activator inhibitor type-1 (PAI-1). A new generation ...
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