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Results 401 - 450 of 727
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Maraganore J M - - 1996
Hirulog therapy has been studied extensively in numerous settings including prevention of DVT, treatment of unstable angina, treatment of acute myocardial infarction during thrombolysis, and prevention of acute complications of PTCA. Being one of the first direct thrombin inhibitors in clinical development, it has had to 'test the waters', so ...
Fresco C - - 1996
OBJECTIVE: To assess the prognostic value of a history of hypertension in patients with acute myocardial infarction (AMI) treated with thrombolysis. DESIGN: Retrospective adjusted analysis of outcome data of patients with AMI randomly allocated to treatment in a controlled study of alteplase versus streptokinase and heparin versus no heparin. SETTING: ...
Karam C - - 1996
OBJECTIVES: We sought to evaluate the influence of the method used to achieve early coronary reperfusion (i.e., intravenous thrombolysis or percutaneous transluminal coronary angioplasty) on the prevalence of late potentials after acute myocardial infarction. BACKGROUND: After myocardial infarction, late potentials are associated with an increased risk of ventricular tachyarrhythmia and ...
Adams J N - - 1996
OBJECTIVE: To establish the incidence of hibernating myocardium after myocardial infarction treated with thrombolysis and to observe differences in the clinical outcome between patients with and without hibernating tissue. METHODS: 41 patients underwent gated positron emission tomography with 18-fluorodeoxyglucose and 13N-ammonia at a median of eight days after first myocardial ...
Gil V M - - 1996
OBJECTIVE: Late thrombolytic treatment (after 6 hours from pain onset) for acute myocardial infarction has been shown to improve survival in a cohort of patients. The mechanisms underlying such benefit have been debated and a controversy exists about the influence of late thrombolysis over left ventricular function as one potential ...
Paul S D - - 1996
Elderly patients have a higher mortality after acute myocardial infarction (MI) yet are treated less aggressively than younger patients. To determine (l) the risk-factor profiles, (2) presentation, (3) management, and (4) hospital outcomes for the elderly (> or = 75 years) compared with middle aged (66 to 74 years) and ...
Isselbacher E M - - 1996
Although the natural history of regional left ventricular (LV) dysfunction after Q-wave and non-Q-wave myocardial infarction (MI) was well defined in the prethrombolytic era, the functional and structural implications of the absence of Q waves after thrombolysis are less clear. Echocardiography was performed within 48 hours of admission (entry) in ...
Verheugt F W - - 1996
Since the introduction of thrombolytic therapy for acute myocardial infarction, the incidence of coronary artery reocclusion has been intensively studied. Also, the prediction and diagnosis of reocclusion by angiographic and clinical variables, as well its invasive and pharmacologic prevention, have gained much attention. By angiographic definition, reocclusion requires three angiographic ...
Kono T - - 1996
OBJECTIVES: The present study investigated whether the onset of acute myocardial infarction and resistance to thrombolysis have similar circadian variations. BACKGROUND: Circadian variations of the onset of acute myocardial infarction and resistance to thrombolysis in the early morning have been reported. Some studies have also reported a secondary peak incidence ...
Lieu T A - - 1996
Coronary angioplasty is being increasingly used as the primary treatment for patients with acute myocardial infarction, but controversy remains over its potential adoption in preference to thrombolysis as standard care. This report summarizes the published evidence on health outcomes after primary angioplasty compared with thrombolysis or no intervention for patients ...
Chawla A K - - 1996
We retrospectively studied 114 consecutive patients of acute myocardial infarction diagnosed in the Accident and Emergency department of our hospital, to determine the percentage of eligible patients who actually received thrombolytic therapy, the number of those excluded from receiving such therapy and the various exclusion criteria. We found that 66 ...
Popović A D - - 1996
This study investigates the impact of thrombolysis on infarct expansion and subsequent left ventricular (LV) remodeling in patients with anterior wall acute myocardial infarction (AMI). We evaluated 51 consecutive patients (24 treated with thrombolysis) with anterior wall AMI by 2-dimensional echocardiography in the following sequence: days 1, 2, 3, and ...
Rawles J - - 1996
OBJECTIVE: To generalise from the results of the Grampian region early anistreplase trial (GREAT) and to express the benefit of earlier thrombolysis in terms of lives saved per hour of earlier treatment. DESIGN: Multivariate analysis of a randomised double blind trial. SETTING: 29 rural practices in Grampian region and teaching ...
Statters D J - - 1996
The independent predictive role of ventricular premature complex (VPC) frequency in the stratification of mortality risk after acute myocardial infarction (AMI) was established in the prethrombolytic era by extensive multicenter trials. Thrombolysis has lead to important changes in the natural history of patients after AMI, so that reassessment of established ...
Cannon CP - - 1996
Rapid achievement of reperfusion with thrombolytic therapy or primary angioplasty has made a dramatic impact an improving the survival of patients with acute myocardial infarction (MI). Restoring infarct-related artery patency early after the onset of MI minimizes infarct size, reduces the degree of left ventricular dysfunction, and improves survival. Several ...
Basher AW - - 1996
Cerebral hemorrhage is the most dreaded complication of coronary thrombolysis. Significant bleeding has also been described from catheter-entry sites, the retroperitoneum, and the gastrointestinal and genitourinary tracts. However, hemoptysis induced by thrombolysis has rarely been described in the literature. We present a 66-year-old male who received front-loaded tissue plasminogen activator ...
Kendall J M - - 1996
OBJECTIVE: To improve the thrombolysis service offered by Gloucester Royal Hospital, by reducing the "door to needle time" (DTN) to 30 min (from a median of 110 min), and increasing the proportion of patients with acute myocardial infarctions receiving thrombolysis to 70% (from 58%). This would be achieved by moving ...
Pucheu S - - 1995
Numerous experimental and clinical studies have reported a role of radical forms of oxygen in the etiology of the manifestations of reperfusion of the ischemic myocardium. However, clinical results remain controversial. The aim of this study was to ascertain the existence of reperfusion-related radical stress after thrombolysis with a marker ...
Brouwer M A - - 1995
OBJECTIVES: This study sought to assess the long-term clinical consequences of reocclusion after coronary thrombolysis. BACKGROUND: After acute myocardial infarction successfully treated with thrombolysis, reocclusion occurs in approximately 30% of patients and leads to poorer in-hospital outcome. However, the long-term effects of reocclusion are unknown. METHODS: Three hundred patients with ...
Vanderschueren S - - 1995
BACKGROUND: Recombinant staphylokinase (STAR) was shown recently to offer promise for coronary arterial thrombolysis in patients with evolving myocardial infarction. The present multicenter randomized open trial was designed to assess the thrombolytic efficacy, safety, and fibrin specificity of STAR relative to accelerated alteplase (recombinant tissue-type plasminogen activator [RTPA]). METHODS AND ...
Zahger D - - 1995
The outcome of patients with Thrombolysis in Myocardial Infarction (TIMI) trial grade 2 flow is worse than that of patients with TIMI grade 3 flow after thrombolytic therapy for acute myocardial infarction. It is unclear whether TIMI grade 2 flow represents incomplete recanalization of the culprit lesion or poor distal ...
Maes A - - 1995
BACKGROUND: Impaired tissue reperfusion after successful recanalization of an epicardial coronary artery has been documented both in animals and in patients with acute myocardial infarction. Whether this phenomenon can be demonstrated with positron emission tomography (PET) and whether it has an effect on late recovery of flow, metabolism, and function ...
Morris D C - - 1995
The role of coronary angioplasty as a means of reperfusion therapy in the patient who suffered an acute myocardial infarction has continued to evolve. Adjunctive angioplasty immediately after thrombolytic therapy has been discarded as a routine therapeutic approach. Rescue angioplasty after failed thrombolysis has limited applicability due to the inability ...
Huettl E A - - 1995
PURPOSE: To evaluate thrombolysis as primary therapy for lower extremity embolic occlusions. MATERIALS AND METHODS: Forty-five of 306 consecutive cases of lower extremity arterial occlusions treated with urokinase and registered in the Society of Cardiovascular and Interventional Radiology Transluminal Angioplasty and Revascularization Registry were believed on the basis of clinical ...
Saltissi S - - 1995
Greater understanding of the underlying pathophysiology of acute myocardial infarction (AMI) has led to more aggressive management and lower mortality, both in-hospital and long term. AMI results mainly from thrombotic occlusion of the infarct-related coronary artery. The ensuing necrosis evolves over a 6-12 h period providing a time window for ...
Topaz O - - 1995
This report discusses a new indication for the use of holmium:YAG laser. It includes facilitation of thrombolysis and plaque ablation in acute myocardial infarction after failure of thrombolytic agents. Further study is required to define optimal utilization and integration of this novel device for patients who fail to respond to ...
Kosuga K - - 1995
In order to clarify the relationship between the patency of the infarcted arteries and subsequent long-term prognosis after thrombolytic therapy, we evaluated 116 patients with acute myocardial infarction treated with intracoronary (112 patients) or intravenous (four patients) urokinase. Patients treated with angioplasty after thrombolysis were excluded. The infarcted vessel was ...
Adams J N - - 1995
The risk of administering thrombolysis to patients with suspected myocardial infarction who subsequently do not sustain an infarct, but develop complications associated with thrombolysis is of concern to all physicians. The objective of this study was to ascertain the effect of altering the criteria for the administration of thrombolysis on ...
Ferlito S - - 1995
The authors carried out a study on the behavior of some thrombotic molecular "markers" in a group of patients suffering from myocardial infarction, just after the first symptoms and after two weeks from the event. The series consists of 12 subjects (6 males, 6 females, mean age 52 +/- 7), ...
Tebbe U - - 1995
OBJECTIVES: The Liquemin in Myocardial Infarction During Thrombolysis With Saruplase (LIMITS) study was instituted to evaluate and characterize the effect of a prethrombolytic heparin bolus (5,000 IU) on the efficacy and safety of saruplase in patients with acute myocardial infarction. BACKGROUND: Heparin has been used after thrombolytic therapy for acute ...
Marzilli M - - 1995
Early administration of thrombolytic agents in acute myocardial infarction lowers mortality and preserves left ventricular function. Currently, only one third of infarct patients receive this treatment, the vast majority being excluded because of restrictive criteria and delayed hospital admission. When correctly administered, thrombolytic therapy achieves reperfusion in 50-85% of occluded ...
Coccolini S S Cardiology Department, S. Maria delle Croci Hospital, Azienda U.S.L. Ravenna, - - 1995
To assess the feasibility, safety and efficacy of thrombolysis in the Emergency Room of a Rural Hospital with no Coronary Care Unit, and subsequent transfer to the Coronary Care Unit of a City Hospital. Prospective study, controlled with two parallel groups of consecutive patients (Group 1: Rural Hospital, Group 2: ...
Grover A - - 1995
The importance of achieving rapid patency of the infarct-related artery during acute myocardial infarction has become well recognized. Early, sustained patency of the infarct-related vessel correlates with improved left ventricular function, better in-hospital outcomes, and lower mortality. Various strategies designed to improve early patency, including "prehospital" thrombolysis, use of an ...
Aguirre F V - - 1995
Intravenous thrombolysis has become a primary mode of reperfusion therapy for selected patients with acute myocardial infarction. The timing and potential benefits of cardiac angiography and coronary revascularization after thrombolysis in patients experiencing an uncomplicated myocardial infarction have been extensively studied, but remain clinically controversial. This review discusses the potential ...
Mooe T - - 1995
OBJECTIVES: To examine the incidence of left ventricular thrombus in patients with anterior myocardial infarction, with and without streptokinase treatment. To identify predictors of thrombus development. DESIGN: Consecutive patients prospectively studied during the hospitalized period. Echocardiography was performed within 3 days of admission and before discharge. SETTING: Ume? University Hospital, ...
Pinto Y M - - 1995
OBJECTIVES: This study sought to determine whether patients who are homozygous for the deletion (D)-type allele of the angiotensin-converting enzyme gene display augmented ventricular dilation after myocardial infarction. BACKGROUND: Recent evidence suggests that the deletion-type allele of the angiotensin-converting enzyme gene (DD genotype) is associated with an increased prevalence of ...
O'Callaghan P A - - 1995
OBJECTIVE: To assess the use of acute coronary care facilities in the Republic of Ireland with regard to case mix, patient characteristics, mortality and factors associated with mortality, time intervals to admission, utilisation of thrombolysis, and risk factor profiles. DESIGN: A 1 week prospective census of all hospitals admitting acute ...
Lincoff A M - - 1995
To determine whether pharmacologic reperfusion to Thrombolysis in Myocardial Infarction (TIMI) grade 2 flow during acute myocardial infarction confers the same clinical benefit as restoration of TIMI 3 flow, in-hospital clinical and angiographic outcomes in 1,229 patients prospectively enrolled in the Thrombolysis and Angioplasty in Myocardial Infarction trials were analyzed. ...
Hannaford P - - 1995
BACKGROUND: Recent guidelines recommend that patients with obvious acute myocardial infarction receive thrombolysis, unless contraindicated, within 60-90 minutes of summoning assistance. If this target is to be achieved, an increasing number of general practitioners are likely to be involved in the administration of thrombolytic agents. AIM: This study aimed to ...
Suzuki S - - 1995
Using the centerline method in a canine model, we compared left ventricular function after coronary thrombolysis induced by a novel modified recombinant tissue plasminogen activator (rt-PA) (E6010: 84Cys-->84Ser) to that induced by rt-PA or urokinase. Thirty minutes after occlusion, a bolus injection of E6010 (0.2 mg/kg) or a continuous infusion ...
Ohlin H - - 1995
OBJECTIVES: To evaluate an increase in plasma concentration of thiobarbituric acid reactive substances as a non-invasive biochemical test of reperfusion after thrombolysis and to investigate the relation between the inflammatory response after acute myocardial infarction and the production of the substances. METHODS: Venous samples were taken from 19 patients receiving ...
Kurnik P B - - 1995
BACKGROUND: The frequency of onset of acute myocardial infarction follows a circadian pattern, with a peak incidence between 6:00 AM and noon. Circadian variations have been defined for platelet aggregation, plasminogen-activator inhibitor, and a number of hemostatic and physiological factors, all of which might predispose toward clotting in the late ...
Bates Eric R. - - 1995
Primary angioplasty offers several advantages to thrombolysis for the treatment of acute myocardial infarction. First, most patients are candidates for primary angioplasty. In contrast, only 20--30% meet eligibility criteria for thrombolysis. Second, angioplasty is superior to thrombolysis in achieving infarct artery patency, restoring normal coronary blood flow, and preventing temporary ...
Cairns John A. - - 1995
Randomized trials have demonstrated the overall benefits and risks of thrombolytic therapy for acute myocardial infarction, and have evaluated adjunctive drug therapies, adjunctive and primary angioplasty, various approaches to the timing of thrombolysis, and post-thrombolysis management. Three questions, which remain unanswered, are addressed in this Point-Counterpoint Series. The GUSTO trial ...
Zahger D - - 1995
Smokers with acute myocardial infarction appear to have a better outcome after thrombolysis than do nonsmokers. To identify factors that could contribute to this curious finding, we analyzed data from the Thrombolysis in Myocardial Infarction (TIMI-4) trial, in which 382 patients with acute myocardial infarction were randomized to tissue plasminogen ...
Robinson M B - - 1995
Substantial investments are now being made in quality assurance programmes throughout the developed world. Proposes that economic evaluation is one approach to justifying these in terms of value for money. Three key elements are: comparison with some alternative course of action; measurement of costs; and measurement of consequences. Illustrates the ...
Whitlow P L - - 1995
Despite these negative results, the theoretical benefit of lysing clot in acute coronary syndromes remains appealing. Whether the use of more potent antiplatelet agents or antithrombin agents might improve the results of thrombolytics in unstable angina and acute myocardial infarction without an unacceptable bleeding risk remains speculative. Site-specific lysis with ...
Emmerich K - - 1995
This study reports on 261 consecutive patients admitted to the Wuppertal Heart Center with acute myocardial infarction (186 men, 75 women; average age: 58.2 +/- 11.6 years) and then treated by primary coronary artery angioplasty. Sixteen patients with cardiogenic shock were included, as well as 42 patients aged > or ...
Reeder G S - - 1995
The benefit of thrombolytic therapy for acute myocardial infarction has been conclusively established by many trials. Direct angioplasty (without thrombolytic therapy) is often utilized urgently for patients with acute infarction based on observational studies. Recently, three randomized trials compared outcomes of patients undergoing thrombolysis versus direct angioplasty. The results of ...
Bertrand E - - 1995
Coronary heart disease is still rare representing only 6% of all cardiovascular diseases in black Africans despite its increased incidence in recent years. Myocardial infarction in black Africans shows similar characteristics as those seen in patients aged under 40 years in the west, particularly regarding the frequency of infarction as ...
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