Search Results
Results 451 - 500 of 717
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Vaitkus P T - - 1994
Adjunctive thrombolysis has not been shown to improve angioplasty success or complication rates in elective angioplasty or myocardial infarction and may be detrimental in unstable angina. Thrombolysis of chronically occluded vessels achieves recanalization at a rate comparable to conventional angioplasty and is associated with a high rate of complications and ...
Feld S - - 1994
OBJECTIVES: The purpose of this study was to test the hypothesis that liposomal prostaglandin E1 (TLC C-53) would result in more rapid thrombolysis, less reocclusion and smaller infarct size when administered with heparin and streptokinase in a canine thrombolysis model. BACKGROUND: In experimental animals, prostaglandin E1 has been shown to ...
Pipek R - - 1994
Two brothers with acute myocardial infarction are presented. Subsequent to a standard thrombolysis treatment with streptokinase and heparin, both developed abnormal liver tests, with elevated transaminases only. This liver dysfunction resolved promptly. The occurrence of such side-effects in two siblings raises the question of genetic predisposition to the otherwise uncommon ...
Meijer A - - 1994
BACKGROUND: After successful thrombolysis for acute myocardial infarction, reocclusion is observed in about 30% of patients after 3 months and usually occurs without reinfarction. We studied the impact of reocclusion without reinfarction on global and regional left ventricular function and on remodeling during that period. METHODS AND RESULTS: The patients ...
Popović A D - - 1994
BACKGROUND: It has been shown that successful reperfusion of the infarct-related artery by thrombolysis can prevent left ventricular dilation after acute myocardial infarction; these beneficial effects were detected from several days to several months after infarction. To date, however, no study has shown that these effects can be demonstrated within ...
Currie P - - 1994
We assessed whether audit might reduce the time taken to give thrombolysis and aspirin in patients with acute myocardial infarction (N = 116). A retrospective analysis was performed of the sources of delay in giving the drugs (N-60) and the data were presented to clinical staff accompanied by guidelines aimed ...
Prewitt R M - - 1994
The authors employed a canine model of coronary thrombosis, induced by injection of radioactive blood clot, via a catheter placed in the left anterior descending (LAD) coronary artery, to compare effects of different rates of administration of recombinant tissue plasminogen activator (rtPA) on efficacy of coronary thrombolysis. In one group ...
Schweiger M J - - 1994
The purpose of this study was to analyze angiographic findings, clinical course, and follow-up data on 1,752 patients who underwent protocol cardiac catheterization 18 to 48 hours after enrollment in the Thrombolysis in Myocardial Infarction (TIMI) II pilot and randomized trial: 244 patients (14.0%) had < 60% diameter stenosis in ...
Vogt A - - 1994
Patients from 4 German multicenter studies on thrombolysis in acute myocardial infarction (AMI) were retrospectively evaluated to assess the incidence of optimal reperfusion, defined as a completely perfused infarct vessel after 90 minutes, without subsequent death or reinfarction, and without reocclusion or deterioration of flow in control angiograms. Of 907 ...
Neuhaus K L - - 1994
OBJECTIVES: The aim of this study was to determine the appropriate dose of a novel recombinant tissue-type plasminogen activator (BM 06.022) for thrombolysis in patients with acute myocardial infarction. BACKGROUND: BM 06.022 is a mutant of tissue-type plasminogen activator expressed in Escherichia coli that can be given as a single ...
Beathard G A - - 1994
Chronic hemodialysis, as it is practiced today, is heavily dependent on the use of the expanded polytetrafluoroethylene graft for vascular access, although it is prone to the problem of venous stenosis and its sequela, thrombosis. The natural history of untreated venous stenosis is to decrease the efficiency of dialysis and ...
Kingma J H - - 1994
The study was designed to examine the safety and efficacy of acute interventional use of captopril on left ventricular volumes, ventricular arrhythmias and neurohormones during thrombolysis in patients with a first anterior myocardial infarction, within 6 h of onset of symptoms. Left ventricular dysfunction and prognosis after myocardial infarction can ...
Escaned J - - 1994
We report on the use of intravascular ultrasound, coronary angioscopy and on-line quantitative angiography in an unstable patient soon after myocardial infarction. Combined intracoronary imaging made it possible to solve the therapeutic problem posed by an unusual angiographic appearance secondary to intracoronary thrombolysis during coronary recanalization. The pathological validation of ...
Venegoni P - - 1994
Little is known about the management and treatment of coronary thrombosis in polycythemia vera (PV) [1]. We describe a case of acute myocardial infarction in a patient with recently diagnosed PV and thrombocytosis. The patient underwent emergency catheterization with intracoronary thrombolysis and angioplasty of the left anterior descending coronary artery.
Heymann T D - - 1994
Thrombolysis has been very effective in reducing the morbidity and mortality from acute myocardial infarction. Serious adverse events are not uncommon, however. We describe a case in which a haemopericardium and tamponade developed in a patient with a history of recurrent idiopathic pericarditis and to whom streptokinase had been administered ...
Reiner J S - - 1994
Thrombolytic therapy is widely available and easily administered and can restore IRA flow. IRA patency restored by thrombolysis salvages ventricular function and reduces mortality rates, albeit with an increased risk of hemorrhagic stroke. The risk of coronary reocclusion after t-PA administration can be reduced with concomitant use of intravenous heparin ...
Weaver W D - - 1994
Studies comparing paramedic-initiated and hospital-initiated therapy show that the critical issue is not where or by whom thrombolysis is started but when it is started. Two of the greatest time-savers--and hence modifiers of infarct size and mortality--have been the introduction of the computer-interpreted ECG and simply alerting the hospital that ...
Soskin P - - 1994
To investigate whether von Willebrand's Factor (vWF) changes as a result of the reperfusion strategy during acute myocardial infarction (AMI), vWF was measured on days 0, 1, 2, 3, 4, 5 and 15 in 34 patients with AMI. Thrombolysis was initiated in 22 patients and followed by a coronary angiogram ...
Prewitt R M - - 1994
OBJECTIVES: This study was designed to test the hypothesis that in the presence of moderate hypotension, intraaortic balloon counterpulsation would enhance coronary thrombolysis induced by intravenous administration of recombinant tissue-type plasminogen activator (rt-PA). BACKGROUND: Although many studies have confirmed the efficacy of thrombolytic therapy in acute myocardial infarction, few have ...
Zabel M - - 1994
INTRODUCTION: Little data are available on changes in autonomic tone during the first 24 hours of acute infarction in patients undergoing thrombolytic therapy. Particularly, the association of changes in autonomic tone to reperfusion of the infarct-related artery has not been evaluated in man. Heart rate variability (HRV) is a noninvasive ...
Lear J T - - 1994
We reviewed the ward admission notes of 211 Indian and 192 European patients admitted over a period of 12 months to a coronary care unit. More Indian patients had myocardial infarctions (34% vs 27%, p < 0.05); they were more likely to have diabetes mellitus (47% vs 14%, p < ...
Van de Werf F - - 1994
Thrombolysis has become standard treatment in the great majority of patients with an acute transmural myocardial infarction. Large placebo-controlled trials have shown that thrombolytic therapy, when given within 6 hours after onset of symptoms, reduces infarct size, preserves left ventricular function and improves survival. Because of discrepancies observed between the ...
Rote W E - - 1994
We examined the effectiveness of the direct-acting thrombin inhibitor, recombinant hirudin (r-hirudin), for prevention of coronary rethrombosis after thrombolysis with recombinant tissue plasminogen activator (rt-PA) in a canine model of coronary artery thrombosis. The reocclusion rate of 15-30% associated with thrombolytic therapy emphasizes the need for adjunctive therapy to prevent ...
Neumann F J - - 1994
The study investigated inflammatory responses in evolving myocardial infarction. Fifteen patients with acute myocardial infarction, who had undergone balloon recanalization of the infarct-related coronary artery within 4 h after onset of symptoms, were examined. Blood samples were obtained through the guiding catheter and from the pulmonary artery before and immediately ...
Pedretti R F - - 1994
OBJECTIVES: The aim of the present study was to determine the influence of early thrombolysis on ventricular tachyarrhythmias (clinical and inducible) and heart rate variability in survivors of myocardial infarction at high risk for life-threatening ventricular arrhythmias. BACKGROUND: A greater electrical heart stability may be important in improving survival in ...
Becker R C - - 1994
Following successful coronary arterial thrombolysis, thrombogenic substrate persists, increasing the risk of recurrent thrombosis, reocclusion, and reinfarction. The preferred treatment in this setting has not been established. Although many patients receive mechanical revascularization, it is conceivable that repeat thrombolysis, primarily with tissue plasminogen activator, represents the most readily available and ...
Rawles J - - 1994
OBJECTIVES: Our aim was to determine the time saved by administration of thrombolytic therapy at home rather than in the hospital and to assess whether earlier thrombolysis resulted in decreased mortality from acute myocardial infarction. BACKGROUND: There is much theoretic, experimental and trial evidence to indicate that in acute myocardial ...
Purvis J A - - 1994
OBJECTIVES: The purpose of this study was to assess the efficacy of 150 mg of aspirin plus 100 mg of alteplase, administered as two intravenous bolus injections of 50 mg each given 30 min apart, and followed by intravenous heparin, on infarct-related coronary artery patency (Thrombolysis in Myocardial Infarction [TIMI] ...
Zardini P - - 1993
Infarct expansion, defined as an alteration in the ventricular topography due to thinning and lengthening of the infarcted segment, develops within the first few hours of the acute symptoms, mostly in patients with a large, transmural, anterior myocardial infarction. Shape changes, peculiar to risk region location and due to disparity ...
Topol E J - - 1993
The insights from the Global Utilization of Streptokinase and t-PA for Occluded Arteries (GUSTO) trial have paved the way for further refinement in myocardial reperfusion strategies. For the moment, there is a better pharmacologic approach for achieving rapid and complete coronary thrombolysis. However, for the future, the legacy from this ...
Shani J - - 1993
Recanalization of occluded arteries during acute myocardial infarction has been proven to prolong life and improve left ventricular function. Patients who could not receive thrombolytic therapy for failed thrombolysis and/or angioplasty were treated by mechanical manipulation of the thrombus. Three techniques were used: transcatheter aspiration, clot displacement, and thrombectomy. Five ...
Mittleman M A - - 1993
BACKGROUND: Despite anecdotal evidence suggesting that heavy physical exertion can trigger the onset of acute myocardial infarction, there have been no controlled studies of the risk of myocardial infarction during and after heavy exertion, the length of time between heavy exertion and the onset of symptoms (induction time), and whether ...
Cross D - - 1993
Since 20% of patients with myocardial infarction (MI) have had a previous infarction, and reinfarction within one year after infarction occurs in 9% of cases, it is important to clarify the role of repeat thrombolysis. After streptokinase (SK) administration, IgG antibodies rise to a peak at two weeks and slowly ...
Kingma J H - - 1993
The adjunctive use of ACE-inhibitors with thrombolytic therapy early during acute myocardial infarction offers theoretic advantages. In the acute phase, captopril may scavenge free radicals, blunt the catecholamine response, elicit coronary vasodilation and increase prostacyclin and bradykinin levels. In the chronic phase remodelling may be attenuated. At present, a large ...
Lincoff A M - - 1993
OBJECTIVES: The goal of this study was to investigate whether female gender portends an adverse prognosis independent of the severity of the underlying disease after acute myocardial infarction treated by thrombolysis. A total of 348 women were compared with 1,271 men enrolled in the Thrombolysis and Angioplasty in Myocardial Infarction ...
Terrin M L - - 1993
OBJECTIVES: This report describes the survival and reinfarction rates for 2- and 3-year follow-up in the Thrombolysis in Myocardial Infarction (TIMI) Phase II clinical trial. BACKGROUND: Patients enrolled in TIMI II were randomly assigned to an invasive (1,681 patients) or a conservative (1,658 patients) management strategy to follow receipt of ...
Aylward P - - 1993
The GUSTO II trial will investigate the role of antithrombin therapy in acute coronary syndromes, comparing standard doses of heparin with the specific antithrombin agent recombinant hirudin. The two drugs will be compared as primary therapy in patients with unstable angina or patients with myocardial infarction (MI) unsuitable for thrombolysis, ...
O'Rourke M - - 1993
It is now accepted that the earliest event in acute myocardial infarction is coronary occlusion caused by fissuring of an atherosclerotic plaque, with resultant platelet deposition on the mural flaw and build up of thrombus within the lumen. The symptoms generated are caused by myocardial ischaemia, as first described by ...
Heriot A G - - 1993
Thrombolytic therapy reduces mortality in acute myocardial infarction (AMI), giving maximal benefit with early treatment. In the UK delayed presentation after AMI may reduce the advantages of thrombolysis. To assess this, 103 patients presenting with AMI to two London Hospitals were interviewed to determine the length and cause of delay ...
Farnsworth T A - - 1993
Receipt of thrombolytic therapy in patients aged 75 or over with proven acute myocardial infarction admitted initially to either the coronary care unit (CCU) or a geriatric medical ward (GMW) was studied retrospectively in a hospital administering thrombolysis only in the CCU. Mean age and age distribution of patients admitted ...
Tubaro M - - 1993
A multicenter controlled study versus heparin was conducted to explore the activity of defibrotide, a polydesoxyribonucleotide drug, in preventing reocclusion after urokinase thrombolysis in patients with acute myocardial infarction (AMI). The study involved 137 consecutive patients with AMI and a time from the onset of symptoms < or = 6 ...
Peters R W - - 1993
OBJECTIVES: The purpose of this study was to assess the relation between the time of awakening and the time of onset of acute myocardial infarction. BACKGROUND: Previous investigation has shown the onset of symptoms of acute myocardial infarction to have a primary peak 1 to 2 h after awakening. In ...
Van de Werf F - - 1993
BACKGROUND: K1K2Pu is a recombinant chimeric tissue-type and urokinase-type plasminogen activator consisting of the two kringle domains (K1 and K2) of human tissue-type plasminogen activator (t-PA) and the serine proteinase domain (Pu) of single-chain urokinase-type plasminogen activator (scu-PA). In experimental animal models of thrombosis, its thrombolytic potency has been shown ...
Tebbe U - - 1993
The novel recombinant plasminogen activator (r-PA) (BM 06.022) is a mutant of tissue-type plasminogen activator expressed in escherichia coli which can be given as a bolus because of a prolonged half-life. The primary objective of this trial was to determine the efficacy of an intravenous r-PA double bolus (first bolus ...
McCrea W A - - 1993
OBJECTIVE: To assess, in the context of their possible role in prehospital thrombolysis, the ability of general practitioners to recognise acute transmural myocardial ischaemia/infarction on an electrocardiogram. DESIGN: 150 doctors (every fifth name) were selected from the alphabetical list of 750 on Merseyside general practitioner register and without prior warning ...
Gomez M A - - 1993
Smokers have been reported to have an improved short-term prognosis after myocardial infarction when compared with nonsmokers. This study examines the effect of smoking status on infarct-related artery patency, a determinant of outcome, following thrombolytic therapy for acute myocardial infarction (AMI). To evaluate patency outcome by smoking status, the database ...
Stevenson R - - 1993
OBJECTIVE: To record prognosis and determinants of outcome in patients with acute myocardial infarction since thrombolysis was introduced. DESIGN: Observational study. SETTING: London district general hospital. PATIENTS: 608 consecutive patients admitted to the coronary care unit with acute myocardial infarction between 1 January 1988 and 31 December 1991. MAIN OUTCOME ...
Iosseliani D G - - 1993
The effect of delayed recanalisation of the infarct related artery on clinical course and left ventricular functions was studied in 23 patients with acute myocardial infarction (Group 2). Another 82 patients with acute myocardial infarction served as controls: 48 patients with immediate recanalisation of the infarct related artery following intracoronary ...
Schofer J - - 1993
As part of a prospective randomized double-blind trial (PRIMI) to study the early patency rate of the infarct-related artery after saruplase (INN for recombinant unglycosylated full-length human single-chain urokinase-type plasminogen activator) vs streptokinase in a subgroup of patients, left ventricular function was compared between both treatment groups at 90 min ...
Mendia R - - 1993
BACKGROUND: In selected patients with postinfarction angina and impending reinfarction, thrombolysis with recombinant tissue-type plasminogen activator (rt-PA) or streptokinase is highly effective in avoiding a new myocardial infarction. METHODS: To avoid major cardiac events, we treated 14 consecutive patients with thrombolytic therapy because of impending reinfarction with ECG ST-segment elevation. ...
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