Search Results
Results 251 - 300 of 725
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Dilley S - - 2001
OBJECTIVE: To determine whether the introduction of acute angioplasty referral guidelines would lead to an improvement in decision-making times with respect to thrombolysis for patients with acute myocardial infarction. METHODS: Retrospective and prospective collection of 'time from diagnostic electrocardiogram to treatment' for all patients who received thrombolytic treatment for acute ...
Kucia A M - - 2001
OBJECTIVE: The goal of this study was to determine the effect of a coronary care-trained nurse (CCTN) on transfer times of patients presenting with acute coronary syndromes (ACS) from the emergency department (ED) to the coronary care unit (CCU) for definitive cardiac treatment (DCT). DESIGN: This was a prospective randomized ...
Siegel R J - - 2001
Previous studies have shown that external ultrasound with low frequencies and high intensities can enhance thrombolytic drug-induced clot dissolution during in vitro experiments. In this series of studies, we evaluated the efficacy of peripheral and coronary thrombolysis in vivo in animals by using noninvasive transcutaneous ultrasound combined with thrombolytic drugs ...
Behrens S - - 2001
Systemic treatment with rtPA approved for a 3-hour window is the only established causal therapy for acute stroke in the United States and Canada. Thrombolytic therapy with rtPA demonstrated a small, although significantly reduced morbidity, in a limited number of highly selected patients. As recently shown, intraarterial application is favorable ...
Ogasawara K - - 2001
The aim of this study was to investigate the prognostic utility of post-treatment technetium-99m ethyl cysteinate dimer (99mTc-ECD) single-photon emission tomography (SPET) for predicting ischemic tissue outcome in cases involving embolic middle cerebral artery occlusion treated with local intra-arterial thrombolysis. We examined twenty-five patients with a moderately ischemic area determined ...
Vrachatis A D - - 2001
Following thrombolysis and primary percutaneous transluminal coronary angioplasty (PTCA) for acute ST segment elevation myocardial infarction, basal flow in the culprit artery is known to influence prognosis. The purpose of this study was to determine if differences exist in basal flow in culprit and nonculprit coronary arteries in patients with ...
Gibson C M - - 2001
The establishment of patency (Thrombolysis In Myocardial Infarction [TIMI] grade 2 or 3 flow) and/or TIMI grade 3 flow at 60 minutes after thrombolytic administration is both a univariate and multivariate predictor of in-hospital and 30-day mortality, and the odds ratios for mortality are nearly identical for TIMI grade 3 ...
Rosenschein Uri - - 2001
During high-power ultrasound irradiation in fluids, microbubbles are formed and collapse to generate shock waves and induce fibrinolysis. In vivo, intracoronary injection of ultrasound-lysed clots increased myocardial perfusion. The experience with the ultrasound thrombolysis catheter in the ACUTE (Analysis of Coronary Ultrasound Thrombolysis Endpoints) trial showed that primary percutaneous coronary ...
Larrue V - - 2001
BACKGROUND AND PURPOSE: Intravenous thrombolysis with recombinant tissue plasminogen activator (rtPA) improves the outcome for ischemic stroke patients who can be treated within 3 hours of symptom onset. The efficacy of thrombolysis has been demonstrated despite an increased risk of severe hemorrhagic transformation (HT) in patients treated with rtPA. We ...
Schneweis S - - 2001
Subgroup analyses of data from an open-label study of intravenous recombinant tissue plasminogen activator (rt-PA) administered to stroke patients were performed. Clinical outcome and incidence of intracranial hemorrhage were evaluated in 20 patients diagnosed by transcranial Doppler ultrasound as having proximal middle cerebral artery (MCA) occlusion. Additionally early infarct signs ...
Angeja B G - - 2001
Almost one-third of patients with acute myocardial infarction (AMI) are aged >75 years, and this proportion is expected to increase as the population ages. Mortality and complication rates are particularly high in the elderly, yet reperfusion therapies, including thrombolysis and primary percutaneous transluminal coronary angioplasty (PTCA), are under-utilised among eligible ...
Rabilloud M - - 2001
Our objective was to assess the impact of selected geographic factors and patients' characteristics on thrombolysis rates in patients resident and hospitalised for acute myocardial infarction in three departments of the Rhĵne-Alpes Region (France). We used a two-level hierarchical model to estimate and explain geographic areas' specific effects. Old subjects ...
Bryant M - - 2001
The aim was to compare time to thrombolysis for patients treated via three treatment pathways: thrombolysis in the emergency department (ED), thrombolysis following direct admission by ambulance officers to coronary care (CCU) and thrombolysis after transfer from ED to CCU. We used a retrospective study of time to thrombolysis for ...
McCullough P A - - 2000
The majority of patients with acute myocardial infarction and other acute coronary syndromes (ACS) are considered ineligible for thrombolysis and do not routinely receive reperfusion therapy. We hypothesized that predictors and outcomes of angiographically impaired culprit vessel flow can be identified and compared. This trial evaluated the outcomes following triage ...
Barron H V - - 2000
Elevation of the white blood cell (WBC) count during acute myocardial infarction (AMI) is associated with adverse outcomes. We examined the relationship between the WBC count and angiographic findings to gain insight into this relationship. Results and Methods-We evaluated data from 975 patients in the Thrombolysis In Myocardial Infarction (TIMI) ...
Syed M - - 2000
OBJECTIVE: To analyze the effect of delay times on racial differences in thrombolysis for acute myocardial infarction. BACKGROUND: Lower rates of thrombolytic therapy in blacks with acute myocardial infarction have recently been reported, but the reasons for this disparity are unknown. We hypothesized that lower rates of thrombolysis are caused ...
Chang W C WC University of Alberta, Edmonton, - - 2000
Temporal changes in baseline characteristics, treatment and clinical outcomes of patients presenting with acute ST elevation myocardial infarction in Canada and the United States have not been examined comprehensively over time. To evaluate baseline characteristics, process of care and clinical outcomes. Also, to explore whether earlier process-of-care differences between Canada ...
Silva J A - - 2000
Intracoronary thrombi are harbingers for increased procedural complications after percutaneous revascularization techniques. Current approaches to treat coronary thrombus prior to plaque intervention are pharmacologic and mechanical. Whereas the use of coronary thrombolysis prior to or during percutaneous coronary intervention have yielded mixed results, the group of the platelet IIb/IIIa inhibitors ...
Strandberg L E - - 2000
OBJECTIVES: To assess the long-term prognostic values of baseline demographic data, occurrence of vectorcardiographic signs of reperfusion, left ventricular function and coronary angiographic features. DESIGN: Longitudinal study of morbidity and mortality. SETTING: Coronary care unit at Danderyd Hospital, Stockholm, Sweden. SUBJECTS: A total of 222 patients (mean age 61 years) ...
Chareonthaitawee P - - 2000
OBJECTIVES: To examine the impact of time to thrombolytic treatment on multiple acute outcome variables in a single trial of thrombolysis in acute myocardial infarction. DESIGN AND PATIENTS: Mortality and reinfarction rate were measured in 2770 patients with acute myocardial infarction who received thrombolysis within 12 hours in CORE, an ...
Ludwigs U - - 2000
OBJECTIVE: To study the usefulness of the Second Acute Physiology and Chronic Health Evaluation (APACHE II) scoring system for prognostication of in-hospital mortality in patients with acute myocardial infarction treated with thrombolysis. DESIGN: A prospective validation study was conducted at a medical intensive care unit at a university hospital. Over ...
Massel D - - 2000
BACKGROUND: There is accumulating evidence that thrombolytic therapy is underused among eligible patients with acute myocardial infarction. We sought to determine whether potential errors in electrocardiographic diagnosis might be a contributing factor. METHODS: Seventy-five electrocardiograms were interpreted on 2 separate occasions by 3 cardiologists. Two criteria were compared for thrombolysis ...
Manhapra A - - 2000
BACKGROUND: Previous studies have suggested that thrombolysis is used less often in blacks than in whites. However, whether the greater prevalence of contraindications or less specific electrocardiographic manifestations of myocardial infarction (MI) account for this difference is unclear. METHODS AND RESULTS: We studied 498 consecutive patients (32% blacks) with first ...
Qasim A - - 2000
Prompt treatment with thrombolytic therapy in acute myocardial infarction has been proven to reduce infarct size and mortality. However, reperfusion fails to occur in 30-50% of patients, either due to impaired epicardial artery flow or microvascular occlusion, with these patients experiencing a higher morbidity and mortality. We review the diagnosis ...
Przyklenk K - - 2000
BACKGROUND: Clinical studies have implicated preinfarct angina (brief antecedent ischemia/reperfusion [I/R]) as a predictor of more rapid thrombolysis and lower rates of reocclusion. However, the effects of antecedent ischemia on the efficacy of thrombolysis have not been rigorously assessed. Using a canine model of coronary thrombosis, we aimed to (1) ...
Mattioli A V - - 2000
BACKGROUND: Right ventricular (RV) infarction is frequently associated with highest risk of death and major complications. Doppler echocardiography can be useful in the diagnosis of RV involvement. The goal of this study was to evaluate Doppler echocardiography features associated with RV involvement and a poor prognosis. METHODS: Two-dimensional Doppler echocardiography ...
Martí V - - 2000
A female with mitral valvular disease presented an acute myocardial infarction. She suddenly complained of recurrent chest pain with symptoms of pulmonary edema. The angiogram evidenced multiple coronary thromboemboli. A combined strategy using intracoronary thrombolysis, a platelet glycoprotein IIb/IIIa antagonist (abciximab) and percutaneous transluminal coronary angioplasty to help disrupt the ...
Kharb S - - 2000
OBJECTIVE: Treatment with thrombolysis plays a crucial role in salvaging the myocardium in myocardial infarction (MI) patients, but reperfusion of ischaemic areas may itself be associated with reperfusion injury mediated by free radical induced oxidation. Hence the present study was planned to evaluate oxidative stress in patients receiving thrombolytic therapy ...
Siegel R J - - 2000
BACKGROUND: Limitations of coronary thrombolysis include the time to reperfusion, patency rate, and bleeding. We evaluated the use of noninvasive transcutaneous ultrasound to augment coronary thrombolysis. METHODS AND RESULTS: In 24 dogs, a thrombotic occlusion of the left anterior descending coronary artery was induced and documented by 12-lead ECG and ...
Karmazyn M - - 2000
Myocardial protection through pharmacological approaches represents a large therapeutic challenge and is an important therapeutic strategy in patients with coronary artery disease, particularly after myocardial infarction. Extensive animal experiments have repeatedly demonstrated the efficacy of sodium-hydrogen exchange (NHE) inhibition as a potent cardioprotective approach. The heart possesses primarily the NHE1 ...
French J K - - 2000
OBJECTIVES: To evaluate the corrected Thrombolysis in Myocardial Infarction (TIMI) frame count (CTFC) as a predictor of late survival after myocardial infarction. BACKGROUND: Thrombolysis in Myocardial Infarction flow grades predict late survival after myocardial infarction. The CTFC provides a more reproducible measurement of infarct-related artery blood flow than the TIMI ...
Warren R J - - 2000
BACKGROUND: Myocardial infarction is a common life threatening medical emergency. The mortality remains around 10% and can be influenced by early reperfusion achieved either by thrombolysis or angioplasty. OBJECTIVE: To outline the relative suitability and safety of thrombolysis as a treatment option for myocardial infarction. DISCUSSION: Initial assessment and treatment ...
Zeymer U - - 2000
Acute myocardial infarction (AMI) remains a leading cause of morbidity and mortality in the developed countries. Thrombotic occlusion of a coronary artery has been shown to cause acute myocardial infarction in over 90% of the cases. Early and complete restoration of bloodflow in the infarct-related coronary artery is the principal ...
Appleby Mark A - - 2000
Although the TIMI (Thrombolysis In Myocardial Infarction) flow grade classification scheme is widely used to assess angiographic outcomes, it is limited by poor reproducibility and its categoric nature. The corrected TIMI frame count (CTFC) is a simple, more objective continuous variable index of coronary blood flow that can be broadly ...
Shapira I - - 2000
This community nonrandomized study comprised a consecutive cohort of 1,545 (81% males) < or = 65-year-old patients who survived a first acute myocardial infarction (AMI). The all-cause 4- to 5-year mortality rate was 9% (80% cardiac). Univariate analysis revealed that older age, female gender, hypertension, diabetes, not undergoing thrombolysis, higher ...
- - 1999
To compare the effects on hemostasis and coronary patency of recombinant (rSK) and natural (nSK) streptokinases in patients with acute myocardial infarct (AMI). Patients from 7 hospitals, <70 years old, less than 12 h after the onset of AMI symptoms, with ST segment elevation or bundle branch block, without contraindications ...
Mahaffey K W - - 1999
OBJECTIVES: The Acute Myocardial Infarction STudy of ADenosine (AMISTAD) trial was designed to test the hypothesis that adenosine as an adjunct to thrombolysis would reduce myocardial infarct size. BACKGROUND: Reperfusion therapy for acute myocardial infarction (MI) has been shown to reduce mortality, but reperfusion itself also may have deleterious effects. ...
Zimarino M - - 1999
After failed thrombolysis, rescue coronary angioplasty is performed with the aim of restoring complete flow in the infarct-related artery. The clinical benefit of this strategy has been debated in few clinical trials during the early '90s, and high procedure-related risks, low success and early reocclusion rates seemed to outweigh the ...
Goldhammer E - - 1999
This study was designed to investigate possible diurnal fluctuations in the efficacy of thrombolysis with streptokinase and whether they follow the circadian periodicity which has already been well documented for the time of onset of acute myocardial infarction, transient myocardial ischaemia, sudden cardiac death, thrombotic stroke, and for the efficacy ...
McLaughlin T J - - 1999
OBJECTIVE: To determine demographic and clinical factors associated with delayed thrombolysis in patients with acute myocardial infarction. DESIGN: A retrospective cohort. SETTING: 37 Minnesota hospitals during the time periods October 1992-July 1993 and July 1995-April 1996. PATIENTS: We reviewed the medical records of 776 older patients aged 65 or older ...
Bhatt D L - - 1999
BACKGROUND: Thrombolysis in Myocardial Infarction (TIMI) flow grading is limited by subjectivity and imprecision. The corrected TIMI frame count (cTFC) has been proposed to obviate these problems. We sought to validate the utility of the cTFC in predicting adverse clinical outcomes after reperfusion therapy. METHODS AND RESULTS: We used angiographic ...
Miller J M - - 1999
We evaluated the effects of abciximab treatment during early angioplasty after clinically failed thrombolysis for acute myocardial infarction. In the Global Use of Strategies To Open occluded coronary arteries (GUSTO-III) trial of reteplase versus alteplase for acute infarction (n = 15,059), 392 patients underwent angioplasty a median of 3.5 hours ...
Chandrasekaran S - - 1999
The angiograms of 89 patients were reviewed from the LATE Ancillary Study (randomized trial of recombinant tissue plasminogen activator vs placebo in patients with symptom onset after 6 hours of myocardial infarction) to determine patency of the infarct-related artery (IRA). In the occluded IRA group (n = 35), the incidence ...
Konstantinides S - - 1999
Thrombolytic agents have been consistently demonstrated to dissolve pulmonary thrombi much more rapidly and effectively than heparin alone. Rapid resolution of pulmonary embolism (PE) is accompanied by a significant decrease in pulmonary artery pressure and an improvement in right ventricular function. However, it is no longer than 7 days until ...
Gaul G B - - 1999
The possibility of lysing clots by the direct intravascular application of ultrasound was described first in 1974 in an animal experiment. However research on therapeutic ultrasound for thrombolysis gained momentum in the early 1980s and is now divided into several directions: 1) pharmacological thrombolysis supported by externally applied ultrasound; 2) ...
Elliott G - - 1999
The role of thrombolytic therapy for venous thromboembolism remains uncertain. To date, no well-designed randomized clinical trial has shown that the benefits of thrombolysis exceed the risks for a well-defined subgroup of patients with acute pulmonary embolism. Recent reports have underscored the risks of thrombolytic therapy. The largest multinational registry ...
Zeymer U - - 1999
Long-term follow-up of placebo-controlled thrombolysis trials has proven that the survival benefit from thrombolysis in acute myocardial infarction (AMI) is maintained for up to 10 years. Ongoing research is being conducted with the aim to further improve early restoration of blood flow in the infarct vessel and, thus, reperfusion of ...
Rogers I R - - 1999
OBJECTIVES: To demonstrate how emergency department triage scale and thrombolysis indicator data can be used to document the impact of a substantial increase in resource allocation. METHODS: Descriptive study in an emergency department of an adult tertiary hospital in Perth, Australia during similar periods of the year both before and ...
Jan V - - 1999
Inflammatory response in the atherosclerotic lesions of coronary artery disease, mediated by cellular immune mechanisms is well appreciated. The significance of the immuno-inflammatory processes for the development of acute ischaemic sequelae of these lesions remains unsettled. Fifty patients of acute coronary syndromes were studied for complement components and immunoglobin levels ...
Vinereanu Dragos - - 1999
A 56-year-old man received thrombolysis for an anterior myocardial infarction after chest pain for 18 hours. Ten days later he was readmitted with fever and hemodynamic deterioration. Transesophageal echocardiography demonstrated a thin-walled cavity at the apex of the left ventricle. At operation he was found to have a myocardial abscess, ...
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