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Laham R J - - 1999
Therapeutic angiogenesis using various heparin-binding growth factors is a promising treatment for ischemic heart disease. Single dose intracoronary (IC) or i.v. delivery are most practical for clinical use. This study was designed to investigate the myocardial and tissue deposition of basic fibroblast growth factor (bFGF) after IC and i.v. administration ...
Frick M - - 1999
The present double-blind, placebo-controlled study investigated the effects of intravenous magnesium on heart rate and rate variability in 30 patients with chronic atrial fibrillation. During standardized conditions, intraindividual variation in heart rate and rate variability was low in patients with chronic atrial fibrillation and magnesium had no effect on heart ...
Shibata M - - 1999
Magnesium (Mg) inhibits the influx of calcium in vascular smooth muscle cells. The purposes of this study were to test the hypothesis that an intravenous administration of magnesium might effect the complement response and to determine the effects of a magnesium pretreatment of patients with acute myocardial infarction (AMI) on ...
Kumbasar S D - - 1999
Using a prospective, nonrandomized design, the authors sought to determine whether concomitant use of intraaortic balloon counterpulsation (IABP) and streptokinase in acute anterior myocardial infarction (MI) would improve the in-hospital mortality rate and angiographic findings. The study included 45 patients with an acute anterior MI. All patients received intravenous streptokinase. ...
Anastasiou-Nana M I - - 1999
Intravenous amiodarone has been found useful in the emergent management of life-threatening arrhythmias. Experimental studies have shown that its electrophysiologic effects are proportional to its myocardial concentration. However, early after its intravenous administration, the extent of the concentration of amiodarone in the human myocardium, the site of its action, is ...
Frostfeldt G - - 1999
OBJECTIVES: This randomized, double blind, placebo-controlled pilot trial evaluated the effect of dalteparin as an adjuvant to thrombolysis in patients with acute myocardial infarction regarding early reperfusion, recurrent ischemia and patency at 24 h. BACKGROUND: Low-molecular-weight heparin, given subcutaneously twice daily without monitoring, might be an attractive alternative to conventional ...
Massel D - - 1999
BACKGROUND: A major limitation of streptokinase is the development and persistence of problematic neutralizing antibodies that have the potential to limit the effectiveness of repeat streptokinase therapy. Accordingly, tissue-type plasminogen activator (t-PA) is frequently administered to patients with recurrent infarction presenting more than four days from previous treatment with streptokinase. ...
French J K - - 1999
OBJECTIVE: To assess whether the 90 minute corrected thrombolysis in myocardial infarction frame count (CTFC) in the infarct related artery predicts left ventricular function at 48 hours in patients with myocardial infarction treated with aspirin, streptokinase, and either heparin or Hirulog. DESIGN AND SETTING: Analysis of 251 patients with acute ...
Sajkowska A - - 1999
Recently it has been demonstrated that the administration of n-acetylocysteine (NAC), in combination with streptokinase, significantly diminished oxidative stress in patients with myocardial infarction. The aim of our study was to assess the influence of NAC treatment, as adjunct therapy in an evolving myocardial infarction, on the polymorphonuclear count, superoxide ...
Ising Hartmut - - 1999
Noise has the potential to cause stress reactions. Chronic noise-induced stress accelerates the ageing of the myocardium and thus increase the risk of myocardial infarction. The involved pathomechanisms include acute increase of catecholamines or cortisol under acute noise exposure and an interaction between endocrine reactions and intracellular Ca/Mg shifts. Chronic ...
Hoffmeister H M - - 1998
BACKGROUND: Thrombolytic therapy in patients with acute myocardial infarction (AMI) is hampered by procoagulant effects. In vitro studies have indicated that plasmin stimulation activates the kallikrein-contact-phase system, resulting in thrombin activation. This prospective comparative study was designed to examine the procoagulant effects of streptokinase or alteplase in AMI. METHODS AND ...
Meyer J - - 1998
Saruplase is a relatively new fibrinolytic drug. Dose finding studies indicated that 70-80 mg saruplase given intravenously results in a high perfusion rate. With a 20 mg bolus followed by a 60 mg infusion over 1 h, a rapid and complete restoration of blood flow can be achieved in a ...
White H D - - 1998
Worldwide, streptokinase continues to be used widely in the treatment of myocardial infarction because it is inexpensive and causes fewer intracranial hemorrhages than other thrombolytic regimens. However, in the Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO-I) trial, the 90-minute angiographic Thrombolysis in Myocardial Infarction (TIMI) trial grade ...
Lorenzoni R - - 1998
BACKGROUND: The economic evaluation of the results of the Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Artery (GUSTO) trial found that recombinant tissue plasminogen activator is more cost-effective than streptokinase for the treatment of acute myocardial infarction. AIM: We evaluated the impact on a cost effectiveness ...
Puri G D - - 1998
Laryngoscopy and endotracheal intubation may produce adverse hemodynamic effects. Magnesium has direct vasodilating properties on coronary arteries and inhibits catecholamine release, thus attenuating the hemodynamic effects during endotracheal intubation. We studied 36 patients with coronary artery disease (CAD) scheduled for elective coronary artery bypass grafting to evaluate the hemodynamic effects ...
Rosenfeldt F L - - 1998
Orotic acid (OA), a naturally occurring substance, is a key intermediate in the biosynthetic pathway of pyrimidines. Previous investigations in the heart suggest that orotate can protect recently infarcted hearts against a further ischemic stress and may be beneficial in certain types of experimental cardiomyopathy. At the Hamburg symposium on ...
Pfisterer M - - 1998
OBJECTIVES: We assessed the use and effects of acute intravenous and later oral atenolol treatment in a prospectively planned post hoc analysis of the GUSTO-I dataset. BACKGROUND: Early intravenous beta blockade is generally recommended after myocardial infarction, especially for patients with tachycardia and/or hypertension and those without heart failure. METHODS: ...
Sinkovic A - - 1998
BACKGROUND: The risk for reinfarctions and delays in reperfusion after streptokinase therapy may be caused by the antifibrinolytic effect of platelet-derived type 1 plasminogen activator inhibitor (PAI-1). This study aims to show the relation of pretreatment PAI-1 levels of patients with acute myocardial infarction treated with streptokinase therapy and the ...
Tatu-Chiţoiu G - - 1998
Efficiency and safety of an accelerated regimen of streptokinase (1.5 M.U. over 20 min., 109 patients) has been compared with the standard regimen (1.5 M.U. over 60 min, 119 patients) in 218 patients admitted within the first 6 hours after the onset of the symptoms of acute myocardial infarction. Using ...
- - 1998
The clinical file on reteplase is methodologically sound. A trial versus alteplase involving more than 15 000 patients seen less than 6 hours after myocardial infarction showed that mortality at 30 days was identical in the reteplase and alteplase treatment groups (7.3%). The two treatment groups did not differ either ...
Seelig M S - - 1998
Many activities of magnesium have justified randomized controlled trials of its role in acute myocardial infarction (AMI), which have shown reduction of short term mortality by 25% to over 50%. The Fourth International Study of Infarct Survival (ISIS-4) megastudy failed to confirm these findings, and, based on analysis of pooled ...
Tebbe U - - 1998
OBJECTIVES: This study sought to demonstrate the equivalence of saruplase and streptokinase in terms of 30-day mortality. BACKGROUND: The use of thrombolytic agents in the treatment of acute myocardial infarction is well established and has been shown to substantially reduce post-myocardial infarction mortality. METHODS: Three thousand eighty-nine patients with symptoms ...
Haigney M C - - 1998
OBJECTIVES: We sought to determine whether heart failure results in loss of cardiac magnesium sufficient to alter cellular electrophysiology. BACKGROUND: Free magnesium has numerous intracellular roles affecting metabolism, excitability and RNA synthesis. Total cardiac magnesium content is reduced in heart failure, but it is unclear whether magnesium loss is primary ...
Masip J - - 1998
We report a patient with diffuse pulmonary hemorrhage after streptokinase therapy for acute myocardial infarction. Hemoptysis, anemia, fever, jaundice, progressive bilateral pulmonary infiltrates and severe acute respiratory failure were observed. The patient required mechanical ventilation and recovered successfully. An immunological reaction to a highly antigenic agent such as streptokinase is ...
Otasević P - - 1997
Since the reported incidence of pericardial effusion following thrombolysis is highly variable, we have evaluated 80 consecutive patients with first acute myocardial infarction treated with streptokinase. Two-dimensional echocardiographic studies were performed on days 1, 2, 3, and 7, at 3 and 6 weeks, and 3, 6, and 12 months following ...
Pachaï A - - 1997
The purpose of this study was to establish whether complement activation is the cause of transient hypotension during streptokinase infusion in patients with acute myocardial infarction. Thirteen patients with suspected acute myocardial infarction and treated with streptokinase were included. Complement 3d (C3d) as an indicator of complement activation was assessed ...
Storm W - - 1997
Magnesium is an important cation that has a key role in cellular processes of energy transfer and utilization involving adenosine triphosphate, and influences cell membrane functions. Its antiarrhythmic properties are well-known and it is widely recognized as an adjunct for the treatment of arrhythmias after myocardial infarction and cardiopulmonary bypass. ...
Califf R M - - 1997
We developed a logistic regression model with data from the GUSTO-I trial to predict mortality rate differences in individual patients who received accelerated tissue plasminogen activator (TPA) versus streptokinase treatment for acute myocardial infarction. A nomogram was developed from a reduced version of this model that approximated the underlying risk ...
McCully J D - - 1997
Studies examining the effects of aging on the myocardium have indicated that with advancing age there are anatomical, mechanical, ultrastructural, and biochemical alterations which compromise the adaptive response of the heart and make the senescent myocardium less tolerant to surgically-induced ischemia. With the increased incidence of elderly patients as candidates ...
Winters S L - - 1997
A case is presented in which amiodarone was administered to suppress paroxysmal atrial fibrillation in a patient with an idiopathic cardiomyopathy. Eleven days after initiation of therapy with amiodarone, the patient experienced syncope and was noted to have recurrent episodes of polymorphous ventricular tachycardia. The patient was hospitalized and treated ...
Tsang T S - - 1997
We evaluated allergic reactions in 20,201 patients randomized to the streptokinase arms of The Global Utilization of Streptokinase and t-PA (Tissue Plasminogen Activator) in Occluded Coronary Arteries (GUSTO-I) trial, and tested the hypothesis that patients with streptokinase allergy would exhibit higher mortality. After adjusting for baseline variables and time of ...
Swanson G A - - 1997
Fibrinolytic drug therapy has markedly reduced morbidity and mortality from acute myocardial infarction. As with any other drug therapy, however, benefits are maximal when patients at higher risk for complications can be identified and treatment decisions modified to reduce the chance of adverse events. Streptokinase, a commonly used and inexpensive ...
Frakes M A - - 1997
Intravenous magnesium has been suggested as a treatment for certain emergency conditions for more than 60 years. It is currently proposed to be beneficial in treating asthma, preeclampsia, eclampsia, myocardial infarction, and cardiac arrhythmias. The use and efficacy of the drug, however, are controversial. This article discusses the current state ...
Luciano R - - 1997
Post-haemorrhagic hydrocephalus is assumed to result from obstruction of the cerebrospinal fluid (CSF) pathways by blood clots and subsequent chronic infiltration with collagen. The aim of this work was to evaluate the possibility of preventing permanent shunt dependence by enhancing the endoventricular fibrinolysis by means of an endoventricular streptokinase infusion ...
Beermann B - - 1997
OBJECTIVES: To study the adherence to guidelines concerning fibrinolytic treatment of patients with suspected myocardial infarction and to obtain information on severe events in clinical practice. METHODS: Prospective reporting of all patients admitted for suspected acute myocardial infarction during 4 months in 1994 from 69 (73.4% of all) Swedish coronary ...
Jensen B M - - 1997
Sixty coronary artery bypass grafting patients were randomized to receive either magnesium sulphate or placebo for 4 days postoperatively. The magnesium substitution reduced the duration of atrial fibrillation or flutter (p < 0.05), but not the number of patients developing these arrhythmias. The number of ventricular ectopic beats was also ...
Redwood S R - - 1996
OBJECTIVES: This study sought to examine the effects of magnesium on epicardial action potential duration in patients during early myocardial ischemia. BACKGROUND: Magnesium has been shown to reduce arrhythmias in experimental models of myocardial ischemia. Experimental and clinical observations suggest an effect on repolarization. METHODS: Patients undergoing elective coronary artery ...
Xu C - - 1996
The aim of this study is to test the patency rate and safety of the accelerated streptokinase dose regimen for coronary thrombolysis compared with the conventional one. One hundred and four patients entering three hospitals up to 12 hours after the onset of definite acute myocardial infarction were randomizely treated ...
Theiss W - - 1996
In a prospective, randomized open trial, significantly higher patency rates were observed 60 minutes after beginning fibrinolytic therapy for acute myocardial infarction after administration of 3 million U streptokinase as compared to 1.5 million U (Thrombolysis in Myocardial Infarction [TIMI] grade 2 and 3 in 52% vs 26%; p = ...
Rabbani L E - - 1996
Magnesium possesses numerous salutary effects for the treatment of acute myocardial infarction (AMI). It is a coronary vasodilator, calcium antagonist, afterload reducer, antiarrhythmic, and antiplatelet drug that modulates autonomic function and limits reperfusion injury when administered early in infarction. Various clinical trials of magnesium therapy for AMI have proffered conflicting ...
Shakerinia T T Department of Surgery, Victoria General Hospital, Halifax, - - 1996
To study the effectiveness of magnesium in cardioplegic solution in preventing postoperative arrhythmias and perioperative ischemia. Randomized, control study. The cardiovascular surgery division of a major referral centre for the maritime provinces of Canada. Fifty patients scheduled to undergo coronary artery bypass who had a normal ejection fraction, normal preoperative ...
Douban S - - 1996
Electrolyte balance has been regarded as a factor important to cardiovascular stability, particularly in congestive heart failure. Among the common electrolytes, the significance of magnesium has been debated because of difficulty in accurate measurement and other associated factors, including other electrolyte abnormalities. The serum magnesium level represents < 1% of ...
Thögersen A M - - 1996
Sixty-one patients with non-thrombolytic treated acute myocardial infarction were randomised to open magnesium infusion or control. tPA activity, tPA mass, PAI-1 mass and von Willebrand factor (vWF) were measured in blood samples drawn at entrance and after on average 10 h and 18 h following inclusion in the trial. No ...
Aziz S - - 1996
BACKGROUND AND AIM: The recent introduction of new measurement technology (using ion specific electrodes) makes intraoperative evaluation of blood ionized magnesium (Mg2+, or iMg)--the bioactive fraction of circulation magnesium--possible. The goals of this study were: (1) to examine the longitudinal pattern(s) of change in blood iMg during cardiopulmonary bypass (CPB); ...
Hampton J R - - 1996
As treatments for acute myocardial infarction have grown in number and effectiveness, the post-infarction mortality rate has fallen, and new therapies can provide only a small additional advantage in extending survival. To prove such an advantage of a new drug over its predecessors in the same drug class requires a ...
Galvani M - - 1996
Increases in thrombin activity occur in patients treated with streptokinase, but conjunctive therapy with intravenous heparin does not appear to improve either the rate of early infarct artery patency or survival in patients with acute myocardial infarction. In a recent study we found that concentrations of fibrinopeptide A, a marker ...
Steurer G - - 1996
The concept of reperfusion-induced injury has aroused special interest during the past decade as thrombolysis and direct angioplasty were introduced for early restoration of coronary blood flow in patients with acute myocardial infarction. There is experimental and clinical evidence that oxygen-derived free radicals (oxyradical hypothesis), activation of the complement system ...
Brecher P - - 1996
The renin-angiotensin system has been linked to the pathogenesis of cardiac fibrosis through the use of experimental animal models and by clinical studies. This review emphasizes recent findings implicating the direct action of angiotensin II on cardiac cell types, particularly the cardiac fibroblast, as a causative factor in the development ...
Antman E M - - 1996
Despite improvements in the outcome of patients with acute myocardial infarction (MI) during the past three decades, room for improvement exists in elderly patients and in patients who are not candidates for thrombolysis. Animal models suggest that magnesium supplementation before reperfusion reduces infarct size. Statistical analysis of the randomized trials ...
Seelig M S - - 1996
Infusions of solutions of magnesium sulfate for patients with acute myocardial infarction were shown by a meta-analysis of seven small studies and a larger study of 2316 patients (LIMIT-2) to have clinical efficacy. However, the ISIS-4 study of 58,050 patients found no improvement in short-term mortality rates with magnesium therapy ...
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