Document Detail


Early assessment of outcome by ST-segment analysis after thrombolytic therapy in acute myocardial infarction.
MedLine Citation:
PMID:  7942474     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
As an early marker of outcome, the sum of ST-segment elevation resolution between the electrocardiogram before and 3 hours after initiation of thrombolysis was investigated in 77 patients with acute myocardial infarction. Prospectively, three groups were defined according to complete (> or = 70%, n = 34), partial (< 70% to > or = 30%, n = 26), or no (< 30%, n = 17) ST resolution. There were considerable differences in the enzyme-determined infarct size (alpha-hydroxybutyrate dehydrogenase release for complete, partial, and no ST resolution: 529 +/- 397 IU/L, 689 +/- 484 IU/L, and 1293 +/- 742 IU/L, respectively; p = 0.0001) and the angiographic left ventricular function 1 week later (ejection fraction 58% +/- 10%, 53% +/- 13%, and 43% +/- 12%, respectively, p < 0.01; regional dyssynergic area 24 +/- 19, 39 +/- 23, and 50 +/- 21 U2, respectively, p < 0.01). Early reperfusion as assessed by creatine kinase release measured in 15-minute intervals was 90%, 65%, and 18%, respectively (p = 0.0001). Differences in degrees of ST-elevation resolution at 3 hours may help facilitate timely screening of patients for appropriate therapeutic intervention. Patients with complete ST resolution may be considered for early discharge, and patients with no ST resolution may be candidates for an early invasive approach or additional thrombolytic therapy.
Authors:
R Dissmann; R Schröder; U Busse; M Appel; T Brüggemann; M Jereczek; T Linderer
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  128     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1994 Nov 
Date Detail:
Created Date:  1994-11-18     Completed Date:  1994-11-18     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  851-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiopulmonary, Klinikum Steglitz, Free University Berlin, Germany.
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MeSH Terms
Descriptor/Qualifier:
Clinical Enzyme Tests
Creatine Kinase / blood
Electrocardiography*
Female
Fibrinolytic Agents / therapeutic use
Heart Catheterization
Humans
Hydroxybutyrate Dehydrogenase / blood
Male
Middle Aged
Myocardial Infarction / diagnosis,  drug therapy*,  epidemiology
Prognosis
Prospective Studies
Thrombolytic Therapy*
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Fibrinolytic Agents; EC 1.1.1.-/2-hydroxybutyrate dehydrogenase; EC 1.1.1.30/Hydroxybutyrate Dehydrogenase; EC 2.7.3.2/Creatine Kinase

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