Document Detail

Intracoronary thrombolysis in acute myocardial infarction: duration of ischemia as a major determinant of late results after recanalization.
MedLine Citation:
PMID:  7137045     Owner:  NLM     Status:  MEDLINE    
To define the effect of duration of myocardial ischemia on the late results after successful thrombolysis in patients with acute transmural myocardial infarction, data on 39 patients treated with intracoronary infusion of streptokinase were analyzed. Patients with successful recanalization of infarct vessel and a time lag between onset of symptoms and reperfusion less than 4 hours were assembled in group A1 (n = 15), and patients with successful recanalization but a time lag of more than 4 hours (n = 17) in group A2. Group B consisted of 7 patients with unsuccessful thrombolysis. Coronary anatomy, left ventricular volume, ejection fraction, and regional ejection fraction of infarct area were determined before and 4 weeks after thrombolysis with cineangiography. Serum creatine kinase activity was serially measured. Before intervention, the groups were comparable with regard to age, Killip class, localization of infarction, incidence of previous infarction, Gensini score of coronary anatomy, left ventricular volume, ejection fraction, regional ejection fraction of infarct area, and serum creatine kinase activity. Four weeks after the intervention, patients in group A1 had a higher ejection fraction (59%) and regional ejection fraction of infarct area (39%) than patients in group A2 (ejection fraction: 49%, p less than 0.05; regional ejection fraction: 26%, p less than 0.05) and group B (ejection fraction: 44%, p less than 0.05; regional ejection fraction: 25%, p = 0.05). Peak serum creatine kinase activity measured during the acute illness was lower in group A1 (764 U/liter) than in group A2 (1,580 U/liter, p less than 0.05) and group B (2,106 U/liter, p less than 0.05). Thus, contraction of infarct area was improved and enzymatic estimate of infarct size was reduced after early as compared with late reperfusion in patients with acute myocardial infarction.
F Schwarz; G Schuler; H Katus; M Hofmann; J Manthey; H Tillmanns; H C Mehmel; W Kübler
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  50     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1982 Nov 
Date Detail:
Created Date:  1982-12-18     Completed Date:  1982-12-18     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  933-7     Citation Subset:  AIM; IM    
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MeSH Terms
Coronary Vessels*
Creatine Kinase / blood
Heart Catheterization
Middle Aged
Myocardial Infarction / therapy*
Streptokinase / administration & dosage*,  therapeutic use
Stroke Volume
Time Factors
Reg. No./Substance:
EC Kinase; EC 3.4.-/Streptokinase

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

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