| Early treatment of acute myocardial infarction with intravenous streptokinase. A high-risk syndrome. | |
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MedLine Citation:
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PMID: 3813740 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article |
Journal Detail:
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Title: Archives of internal medicine Volume: 147 ISSN: 0003-9926 ISO Abbreviation: Arch. Intern. Med. Publication Date: 1987 Feb |
Date Detail:
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Created Date: 1987-03-09 Completed Date: 1987-03-09 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0372440 Medline TA: Arch Intern Med Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 237-40 Citation Subset: AIM; IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Angina Pectoris / etiology Female Follow-Up Studies Heart Failure / etiology Humans Male Middle Aged Myocardial Infarction / drug therapy* Recurrence Risk Streptokinase / adverse effects, therapeutic use* Time Factors |
| Chemical | |
Reg. No./Substance:
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EC 3.4.-/Streptokinase |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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