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Goldstein P - - 2005
Acute myocardial infarction (AMI) is the prototype of a real emergency, and both efficacy and speed are necessary for effective management. The advent of thrombolysis therapy has transformed the care of these patients. In fact, the most frequent complication of AMI is sudden death which still occurs within the first ...
Wardlaw Joanna M - - 2005
PURPOSE: To review systematically all reported early computed tomographic (CT) signs in acute ischemic stroke to determine interobserver agreement and the relationship between early CT signs and patient outcome with or without thrombolysis. MATERIALS AND METHODS: A systematic review of the literature was conducted by using Cochrane Stroke Group methodology ...
Sakakura Kenichi - - 2005
A 77-year-old female with two previous inferior myocardial infarctions was transferred to our medical center with a third inferior acute myocardial infarction. Coronary angiography revealed 99% stenosis with rich thrombus in the distal right coronary artery [Thrombolysis in Myocardial Infarction (TIMI) grade 2 flow]. The angiographic appearance of the right ...
Kirtane Ajay J - - 2005
Clinical and angiographic data were analyzed from 929 patients who had ST-elevation myocardial infarction and open epicardial arteries after fibrinolytic therapy. Residual angiographically evident thrombus was associated with more frequent Thrombolysis In Myocardial Infarction (TIMI) grade 2 flow (33.6% vs 26.8%, p = 0.03), higher corrected TIMI frame counts (34 ...
Hara Masahide - - 2005
OBJECTIVES: We tried to elucidate angiographical predictors of no-reflow and to determine a preferable recanalization therapy based on the morphology of lesions. METHODS: Seventy-six patients were randomly assigned into groups to receive primary angioplasty (n = 41) or intracoronary thrombolysis (n = 35). Based on angiography, occlusive infarct-related lesions were ...
Germing A - - 2005
Aggressive antithrombotic medical therapy may increase the rate of access-site complications after percutaneous coronary intervention. Frequently, emergency coronary interventions have to be performed in a situation when thrombolysis therapy was administered as the first-line therapeutic approach in acute myocardial infarction but failed to achieve stable conditions. We analyzed the rate ...
Olivecrona Göran K - - 2005
BACKGROUND: The same mechanisms by which ultrasound enhances thrombolysis are described in connection with non-beneficial effects of ultrasound. The present safety study was therefore designed to explore effects of beneficial ultrasound characteristics on the infarcted and non-infarcted myocardium. METHODS: In an open chest porcine model (n = 17), myocardial infarction ...
Doyle Frank - - 2005
BACKGROUND: Shorter time to treatment is associated with lower mortality in acute coronary syndromes (ACS). A previous (1994) survey showed substantial delays for acute myocardial infarction (AMI) in Ireland. The present study compared current practice with 1994 and surveyed acute coronary syndromes as a more complete contemporary evaluation of critical ...
Mohammad Yousef M - - 2004
The last decade witnessed significant and unprecedented advances in the treatment of acute ischemic stroke. Intravenous tissue plasminogen activator and defibrinogenating agent are both now approved by the Food and Drug Administration for treatment of acute ischemic stroke within 3 h of symptom onset. Trials involving intra-arterial thrombolysis have demonstrated ...
Schömig Albert - - 2004
OBJECTIVES: This study was conducted to assess whether coronary stenting produces better results compared with balloon angioplasty in patients with acute myocardial infarction (AMI) after failed thrombolysis. BACKGROUND: Little evidence exists on the value of rescue mechanical reperfusion after failed thrombolysis. METHODS: This open-label, randomized study enrolled 181 patients with ...
Wong Selwyn P - - 2004
After ST-elevation myocardial infarction, the association between left ventricular sphericity (measured by biplane ventriculography) and survival rate at a median of 6.5 years was determined in 825 patients. The highest tertile of sphericity (vs the lowest and middle tertiles) was associated with a decreased 10-year survival rate in patients who ...
Turhan Hasan - - 2004
BACKGROUND: Endothelium plays an important role in regulating coronary vascular tone. In addition, several of cardiovascular risk factors that are associated metabolic syndrome have been reported to be associated with endothelial dysfunction. In the present study we aimed to evaluate the coronary blood flow in patients with metabolic syndrome by ...
Kollmar Rainer - - 2004
Thrombolysis (T) is limited by reperfusion-associated injury and the short therapeutic window after stroke onset. The present study investigates whether hypothermia alone or in combination with thrombolysis has beneficial effects after experimental thromboembolic stroke. Wistar rats (n = 60) were subjected to thromboembolic occlusion (TE) of the middle cerebral artery ...
Hayashi Takahiro - - 2004
The efficacy of combined thrombolysis and angioplasty for the purpose of coronary reperfusion after acute myocardial infarction has been controversial. The present study was conducted, therefore, to evaluate the effects of angioplasty following administration of conventional thrombolytic agents on the long-term prognosis of acute myocardial infarction patients. A total of ...
Brophy James M - - 2004
Primary angioplasty is increasingly being advocated as the preferred approach for treating acute ST-segment elevation myocardial infarction regardless of whether interinstitutional transfer is required. This review critically analyzes the evidence comparing primary angioplasty with thrombolytic therapy and concludes that reasonable health care professionals may still find considerable uncertainty about the ...
Avorn Jerry - - 2004
Thrombolytic therapy decreases the mortality rate in patients with acute myocardial infarction (AMI), and the timing of thrombolysis has proved to be critical for decreasing the short-term mortality rate. Much less is known about the longer term consequences of delays in thrombolysis, particularly for outcomes other than the mortality rate. ...
Ooi Adrian - - 2004
Although there is increasing number of reported spontaneous coronary artery dissection (SCAD) recently, this is the first successful operative case of myocardial revascularization on triple-vessel SCAD. Emergency coronary artery bypass grafting was performed on a 42-year-old female presented with acute myocardial infarction, who had failed thrombolysis with on-going angina and ...
Bybee Kevin A - - 2004
The characteristics of 16 women with transient left ventricular (LV) apical ballooning syndrome in a United States population are presented. Additionally, Thrombolysis In Myocardial Infarction (TIMI) frame counts were evaluated during the acute period. Patients generally presented with anterior ST-elevation acute coronary syndrome in the absence of obstructive coronary disease. ...
McCarron Mark O - - 2004
Intracerebral haemorrhage is a complication of thrombolytic therapy for acute myocardial infarction, pulmonary embolism, and ischaemic stroke. There is increasing evidence that cerebral amyloid angiopathy (CAA), which itself can cause haemorrhage (CAAH), may be a risk factor for thrombolysis-related intracerebral haemorrhage. CAAH and thrombolysis-related intracerebral haemorrhage share some clinical features, ...
Ottesen Michael Mundt - - 2004
BACKGROUND: Prompt hospital admission is essential when treating acute coronary syndrome. Delay prior to admission is unnecessarily long. Therefore, a thorough scrutiny of the influence of characteristics, circumstantial and subjective variables on elements of prehospital delay among patients admitted with acute coronary syndrome is warranted. METHODS: A structured interview was ...
Janardhanan Rajesh - - 2004
OBJECTIVES: We aimed to evaluate the ability of vasodilator myocardial contrast echocardiography (MCE) to detect significant infarct-related artery (IRA) stenosis and multivessel disease (MVD) after thrombolysis. BACKGROUND: The detection of residual IRA stenosis subtending significant viable myocardium and the identification of MVD may help to triage patients who may benefit ...
Binbrek Azan S - - 2004
To determine whether tenecteplase (TNK-t-PA), a bioengineered variant of tissue-type plasminogen activator (t-PA) designed to accelerate thrombolysis, exhibits favorable properties compared with those of alteplase, 266 men were studied </=6 hours after the onset of symptoms and signs of acute myocardial infarction. The primary end point was the rapidity of ...
Ndrepepa Gjin - - 2004
The aim of study was to examine the efficacy of reduced-dose alteplase plus abciximab versus alteplase alone by quantifying the amount of myocardium salvaged using myocardial scintigraphy. This study analyzed 150 patients with acute myocardial infarction who received alteplase (69 patients) or reduced-dose alteplase plus abciximab (81 patients) in the ...
Meyners W - - 2004
A 51 year-old male was admitted to our institution with subacute inferior myocardial infarction. Coronary angiography showed thrombotic occlusion of the right coronary artery. Percutaneous coronary intervention including the delivery of 3 stents was unsuccessful (TIMI grade 0 flow). In addition to an ongoing systemic administration of tirofiban, a glycoprotein ...
Atar Shaul - - 2004
Reperfusion strategies in acute myocardial infarction and thrombotic vascular occlusion are focused on rapid and complete restoration of antegrade flow in the infarct-related artery in order to maximize myocardial salvage. Due to the limitations of fibrinolytic agents in restoration of vascular flow, ultrasonic clot dissolution alone and concomitantly with fibrinolytic, ...
Vetrano Alfredo - - 2004
The clinical outcome of 48 consective patients with myocardial infarction who received tirofiban for unsuccessful thrombolysis was compared with that of 48 patients matched for age, gender, and infarct location who did not receive rescue treatment. Those who received tirofiban had more successful reperfusions, and there were few bleeding complications.
Menon Jay - - 2004
Venous thromboembolism is a common problem in hospital and community patients and is associated with longer hospital stays, significant morbidity, and mortality. It is the third most common cardiovascular disease after ischemic coronary artery disease and stroke. A quarter of patients with acute myocardial infarction and more than half of ...
Elsman Peter - - 2004
BACKGROUND: In patients with acute myocardial infarction, estimation of infarct size by cumulative lactate dehydrogenase release at 72 h (LDHQ(72)) is a simple and widely used method. Our objective was to study the value of estimating infarct size, by the cumulative release of LDH over 72, 60, 48 and 36 ...
Lamfers Evert J P - - 2004
BACKGROUND: This study investigated the incidence of abortion of myocardial infarction and of unjustified fibrinolysis by using automated versus cardiologist-assisted diagnosis of acute ST-elevation myocardial infarction. The results of prehospital diagnosis and treatment (2 cities in the Netherlands) were compared with those of inhospital treatment. Unjustified fibrinolysis must be differentiated ...
Kirtane Ajay J - - 2004
We hypothesized that absolute and relative neutrophilia would be associated with adverse angiographic outcomes in the 394 patient Limitation of Myocardial Infarction Following Thrombolysis in Acute Myocardial Infarction (LIMIT) Acute Myocardial Infarction (AMI) trial of fibrinolysis in ST-elevation myocardial infarction. The mean neutrophil count was 7.9 x 10(9)/L, with a ...
Steffenino Giuseppe - - 2004
BACKGROUND: The aim of this study was to observe the outcomes of high-risk patients with acute myocardial infarction treated with primary angioplasty and intravenous thrombolysis in a community setting. METHODS: A prospective study of the in-hospital and 12-month outcomes was conducted in 17 cardiology centers where primary angioplasty was available, ...
Halkin Amir - - 2004
The importance of sustained patency of the infarct-related artery after primary percutaneous coronary intervention for acute myocardial infarction is controversial. We examined serial measures of left ventricular function and clinical outcomes in 280 patients with an initially occluded infarct artery in whom Thrombolysis In Myocardial Infarction trial grade 3 flow ...
Straub Stefan - - 2004
BACKGROUND AND PURPOSE: In acute ischemic stroke, thrombolytic treatment with recombinant tissue plasminogen activator (rtPA) is limited by a concomitant activation of the coagulatory system, leading to incomplete or delayed reperfusion, microcirculatory disturbances, or even repeated vessel occlusions. Our pilot study sought to assess the therapeutic potential of a new ...
Packer Claire - - 2004
OBJECTIVES: To describe the adoption and take up of thrombolytic agents for acute myocardial infarction since 1980 in England and compare use with the estimated ceiling of need. METHODS: Data on national sales and use of thrombolysis since 1980 (supplied by IMS Health) was used to draw an adoption and ...
Nakano Shinichi - - 2004
Thrombolysis has become accepted as an effective treatment for acute ischemic stroke. However, two major problems remain: failure of recanalization and hemorrhagic complications. The combined use of mechanical recanalization techniques with thrombolytic agents occasionally may be required to improve recanalization rates and to reduce hemorrhagic complications. Percutaneous transluminal angioplasty (PTA), ...
Cook Alison - - 2004
OBJECTIVES: To investigate the factors that influenced the adoption and diffusion of thrombolysis in acute myocardial infarction in England and to verify usage data from 1981 to 2001. METHODS: Survey of cardiologists in England using a pre-prepared time line of historical events and a plot of thrombolysis diffusion since 1981. ...
Gorchakova Olga - - 2004
The Pl(A) polymorphism of the platelet glycoprotein IIIa gene is associated with altered platelet function and response to antiplatelet drugs. We sought to assess whether the Pl(A) polymorphism influences myocardial salvage achieved by reperfusion therapy in patients with acute myocardial infarction. We analyzed 292 patients enrolled in 2 randomized trials ...
Neumann-Haefelin T - - 2004
BACKGROUND AND PURPOSE: Early reperfusion is one of the best predictors of good outcome after acute middle cerebral artery (MCA) occlusion. The purpose of this study was to analyze the frequency and relevance of incomplete recanalization for tissue and clinical outcome. METHODS: From a larger acute stroke database (Kompetenznetzwerk Schlaganfall ...
Lee Souki - - 2003
BACKGROUND: Transthoracic Doppler echocardiography (TTDE) enables evaluation of distal left anterior descending coronary artery (LAD) flow. The purpose of this study was to test whether TTDE can differentiate coronary reperfusion with Thrombolysis in Myocardial Infarction (TIMI) grade 3 from TIMI grade < or =2 in patients with anterior acute myocardial ...
Zairis Michael N - - 2003
BACKGROUND: The aim of this study was to evaluate the possible relationship between the degree of physical activity at the onset of myocardial infarction and thrombolysis outcome. METHODS: A total of 351 consecutive patients, who underwent thrombolysis due to ST elevation acute myocardial infarction, were prospectively studied. Patients were classified ...
Sakamoto Tomohiro - - 2003
OBJECTIVES: We examined whether activated protein C (APC) is an effective conjunctive therapy to thrombolysis in patients with ST-segment-elevated acute myocardial infarction (AMl). BACKGROUND: Activated protein C possesses both systemic anticoagulant and anti-inflammatory properties. It has been also shown to enhance fibrinolysis by inhibiting plasminogen activator inhibitor (PAI) activity in ...
Spiers Christine M - - 2003
The primary objective in managing a patient with ST segment elevation myocardial infarction (STEMI) is to establish reperfusion in the infarct-related artery and to maintain it. Two approaches to coronary reperfusion are used in the UK - primary angioplasty and intravenous thrombolysis. Primary angioplasty is the gold standard approach to ...
Bennermo M - - 2003
OBJECTIVES: To investigate the prognostic value of plasma C-reactive protein (CRP) and fibrinogen determinations in patients with acute myocardial infarction treated with thrombolysis. DESIGN: Longitudinal study of morbidity and mortality. SETTING: Coronary care unit at Danderyd Hospital, Stockholm, Sweden. SUBJECTS: A total of 222 patients aged 75 years or below, ...
Bredmose Per P - - 2003
This study reports the experience gained in prehospital thrombolysis in acute myocardial infarction in a sparsely inhabited remote area of northern Norway. The study was retrospective from 1992 to 1999. The area covered was 49 000 km2, with a population of 75 000. During the study period only one out ...
Scheller Bruno - - 2003
OBJECTIVES: The Southwest German Interventional Study in Acute Myocardial Infarction (SIAM III) investigated potentially beneficial effects of immediate stenting after thrombolysis as opposed to a more conservative treatment regimen. BACKGROUND: Treatment of acute myocardial infarction (AMI) by thrombolysis is compromised by Thrombolysis In Myocardial Infarction (TIMI) 3 flow rates of ...
Pedley David K - - 2003
To evaluate a system of prehospital thrombolysis, delivered by paramedics, in meeting the national service framework's targets for the management of acute myocardial infarction. Prospective observational cohort study comparing patients with suspected acute myocardial infarction considered for thrombolysis in the prehospital environment with patients treated in hospital. The catchment area ...
Nikiforos Savas - - 2003
BACKGROUND: Increased QT interval dispersion (QTd) has been found in patients with acute myocardial infarction (AMI). In previous studies this has been shown to decrease with thrombolysis. HYPOTHESIS: The aim of this study was to compare the effects of reperfusion by primary percutaneous transluminal coronary angioplasty (PTCA) and by thrombolysis ...
Katritsis Demosthenes - - 2003
Myocardial reperfusion is the treatment of choice in acute myocardial infarction. Pharmacological thrombolysis restores coronary artery patency in about two thirds of patients with acute myocardial infarction. However, mechanical reperfusion with primary angioplasty and stenting achieves higher patency rates with less complications, especially in high-risk patients. Adjunctive pharmacotherapy and new ...
Spöhr F - - 2003
Acute myocardial infarction (MI) and massive pulmonary embolism (PE) are the underlying causes of cardiac arrest in more than 70% of patients. Thrombolysis is an effective therapy for patients presenting with acute MI or massive PE and has experimentally shown to have beneficial effects on the microcirculatory reperfusion after cardiac ...
Krupicka Jirí - - 2003
The main aim of the present study was to investigate whether long distance interhospital transport for primary angioplasty (delayed mechanical reperfusion) influences the resulting left ventricular function after myocardial infarction as compared with thrombolysis at the nearest hospital (immediate pharmacological reperfusion). Primary coronary angioplasty is more effective than thrombolysis in ...
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