Document Detail

Immediate PTCA after successful thrombolysis with intracoronary streptokinase, three years follow-up. A matched pair analysis of the effect of PTCA in the randomized multicentre trial of intracoronary streptokinase, conducted by the Interuniversity Cardiology Institute of The Netherlands.
MedLine Citation:
PMID:  2968248     Owner:  NLM     Status:  MEDLINE    
Immediate PTCA following thrombolysis with streptokinase was performed in 46 out of 533 patients enrolled in a multicentre randomized trial of early reperfusion in patients with acute myocardial infarction. Additional effects of PTCA in patients with a residual diameter stenosis in the infarct-related coronary artery of 70% or more after thrombolysis were compared with successful thrombolysis alone in a matched pair analysis. Thirty six pairs of patients were formed identical with respect to the infarct related coronary artery, presence or absence of previous myocardial infarction, total ST segment elevation on the ECG at admission to the trial, and delay between onset of symptoms and hospital admission. PTCA after thrombolysis did not lead to additional limitation of infarct size, nor to further preservation of left ventricular function. Infarction rate during the three-year follow-up was 14% after PTCA versus 30% after thrombolysis alone (P = 0.05). Similarly, patients had less angina or heart failure after PTCA, since on average 128 out of 156 weeks follow-up were symptom free, while this was only 102 weeks after thrombolysis alone (P = 0.03). Immediate PTCA after thrombolysis with intracoronary streptokinase seems to prevent recurrent ischemia and reinfarction. Further studies should address the proper indication and timing of PTCA after thrombolysis.
F Vermeer; M L Simoons; P J de Feyter; F W Bär; H Suryapranata; P Fioretti; P W Serruys; B Buis; J C Res; S H Braat
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  European heart journal     Volume:  9     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  1988 Apr 
Date Detail:
Created Date:  1988-08-08     Completed Date:  1988-08-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  346-53     Citation Subset:  IM    
Department of Cardiology, University Hospital Maastricht, University of Limburg, The Netherlands.
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MeSH Terms
Angioplasty, Balloon*
Clinical Trials as Topic
Coronary Vessels
Fibrinolytic Agents / administration & dosage,  therapeutic use*
Middle Aged
Myocardial Infarction / drug therapy
Myocardial Revascularization
Random Allocation
Streptokinase / administration & dosage,  therapeutic use*
Time Factors
Vascular Patency
Reg. No./Substance:
0/Fibrinolytic Agents; EC 3.4.-/Streptokinase

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