| Low-dose tissue plasminogen activator followed by planned rescue angioplasty reduces time to reperfusion for acute myocardial infarction treated at community hospitals. | |
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MedLine Citation:
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PMID: 11665796 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The time from admission to reperfusion in patients with acute myocardial infarction (AMI) was compared according to the type of hospital and treatment strategy. A total of 164 patients with a first AMI within 12h of onset were enrolled at one tertiary emergency center (TEC) and 6 community hospitals (CHs). The subjects were randomly assigned to receive either primary percutaneous transluminal coronary angioplasty (PTCA) (TEC-primary PTCA and CHs-primary PTCA groups) or 800,000 units of intravenous monteplase, half the standard dose of a mutant tissue plasminogen activator (t-PA), followed by rescue PTCA if the Thrombolysis in Myocardial Infarction (TIMI) flow grade was 2 or less (TEC-monteplase and CHs-monteplase groups) on the first coronary angiogram. Sixty minutes after admission, TIMI flow grade 3 rates of the study groups were as follows, in descending order: TEC-monteplase group, CHs-monteplase group, TEC-primary PTCA group, and CHs-primary PTCA group (56%, 41%, 36%, and 8%, respectively; p<0.01). However, there was no significant difference in the final TIMI flow grade 3 rate among the 4 groups. In the CHs, the peak creatine kinase tended to be lower in the monteplase group than in the primary PTCA group. The results suggest that low-dose monteplase followed by rescue PTCA is an effective strategy for promoting early reperfusion in patients with AMI, especially those who are treated at CHs. |
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Authors:
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K Kimura; K Tsukahara; T Usui; J Okuda; Y Kitamura; M Kosuge; T Sano; S Tohyama; O Yamanaka; Y Yoshii; S Umemura |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Japanese circulation journal Volume: 65 ISSN: 0047-1828 ISO Abbreviation: Jpn. Circ. J. Publication Date: 2001 Oct |
Date Detail:
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Created Date: 2001-10-22 Completed Date: 2002-11-19 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7806868 Medline TA: Jpn Circ J Country: Australia |
Other Details:
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Languages: eng Pagination: 901-6 Citation Subset: IM |
Affiliation:
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Division of Cardiology, Yokohama City University Medical Center, Japan. c-kimura@urahp.yokohama-cu.ac.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angioplasty, Transluminal, Percutaneous Coronary* / adverse effects, standards Clinical Protocols Creatine Kinase / blood Female Hospitals, Community / methods, standards Humans Male Middle Aged Myocardial Infarction / complications, therapy* Myocardial Reperfusion / adverse effects, methods*, standards Thrombolytic Therapy Time Factors Tissue Plasminogen Activator / administration & dosage* |
| Chemical | |
Reg. No./Substance:
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EC 2.7.3.2/Creatine Kinase; EC 3.4.21.68/Tissue Plasminogen Activator |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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