Document Detail

Early treatment of acute myocardial infarction with intravenous streptokinase. A high-risk syndrome.
MedLine Citation:
PMID:  3813740     Owner:  NLM     Status:  MEDLINE    
Fifty-one successive patients treated with intravenous streptokinase 1.7 +/- 0.8 (mean +/- SD) hours after onset of symptoms of acute myocardial infarction were evaluated during a three-month posthospital follow-up period. Coronary angiography was performed four to nine days after the initial hospital admission. Twenty-eight patients had a second late angiogram. Forty-one patients had successful reperfusion but only 25% of all patients were without significant clinical cardiovascular manifestations during this period. Postmyocardial infarction angina pectoris occurred in 21 patients, an abnormal stress test result was present in 28 patients, eight patients developed congestive heart failure, and five patients had reinfarction. An intervention with percutaneous transluminal coronary angioplasty or coronary artery bypass graft was performed in 15 (37%) of 41 reperfused patients. A significantly higher intervention rate was present in patients treated with streptokinase within one hour following the onset of symptoms. Early reocclusion (within three months of the infarct) was noted in patients with 60% or more residual stenosis in their infarct-related coronary artery. These patients also had a significantly greater incidence of angina pectoris. Our findings indicate that early thrombolytic therapy of acute myocardial infarction preserves myocardium, and since the infarct-related artery is patent, but narrowed, the jeopardized area is responsible for a high-risk syndrome with an increased likelihood of ischemic symptoms. An early aggressive approach may be indicated, especially for patients with greater than 60% residual stenosis in their infarct-related coronary artery.
G Koren; M H Luria; A T Weiss; M Kriwisky; M Mosseri; C Lotan; D Applebaum; S Welber; D Sapoznikov; Y Ben-David
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of internal medicine     Volume:  147     ISSN:  0003-9926     ISO Abbreviation:  Arch. Intern. Med.     Publication Date:  1987 Feb 
Date Detail:
Created Date:  1987-03-09     Completed Date:  1987-03-09     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0372440     Medline TA:  Arch Intern Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  237-40     Citation Subset:  AIM; IM    
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MeSH Terms
Angina Pectoris / etiology
Follow-Up Studies
Heart Failure / etiology
Middle Aged
Myocardial Infarction / drug therapy*
Streptokinase / adverse effects,  therapeutic use*
Time Factors
Reg. No./Substance:
EC 3.4.-/Streptokinase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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