| Non-invasive detection of early infarct vessel patency by resolution of ST-segment elevation in patients with thrombolysis for acute myocardial infarction; results of the angiographic substudy of the Hirudin for Improvement of Thrombolysis (HIT)-4 trial. | |
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MedLine Citation:
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PMID: 11350109 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Aims The purpose of this study was to validate ST segment resolution as a non-invasive marker for patency of the infarct-related artery 90 min after the start of streptokinase therapy in patients with acute myocardial infarction. Methods and Results In the HIT-4 angiographic substudy, 447 patients with acute myocardial infarction </=6 h received 1.5 million IU streptokinase. Angiograms of the infarct vessel were obtained after 90 min and 12-lead ECGs at baseline and after 90 min. The best cut-off points for a correct prediction of 90 min infarct vessel patency (TIMI 2/3 flow) and complete patency (TIMI 3) were 30% ST resolution and 40% ST resolution, respectively (specificity 68% and 69%, sensitivity 76% and 75%). Prediction of infarct vessel patency by ST resolution in steps of 10% displayed a gradual increase in patency rates. Patients with > or =70% ST resolution (n=70) had a 92% probability of TIMI 2/3 flow, while <30% ST resolution (n=172) was associated with the absence of TIMI 3 flow in 84% of patients. Conclusions Despite fairly good sensitivities and specificities the prediction of infarct vessel patency by ST resolution in the individual patient is limited. However, patients with > or =70% ST resolution are likely to have a patent infarct artery and <30% ST resolution predicts epicardial vessel occlusion or, since persistent ST elevation reflects the existing ischaemic myocardial injury, absence of myocardial perfusion. |
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Authors:
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U Zeymer; R Schröder; U Tebbe; G P Molhoek; K Wegscheider; K L Neuhaus |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: European heart journal Volume: 22 ISSN: 0195-668X ISO Abbreviation: Eur. Heart J. Publication Date: 2001 May |
Date Detail:
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Created Date: 2001-05-14 Completed Date: 2001-09-06 Revised Date: 2009-11-03 |
Medline Journal Info:
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Nlm Unique ID: 8006263 Medline TA: Eur Heart J Country: England |
Other Details:
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Languages: eng Pagination: 769-75 Citation Subset: IM |
Copyright Information:
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Copyright 2001 The European Society of Cardiology. |
Affiliation:
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Medizinische Klinik II, Klinikum Kassel, Mönchebergstrasse 41-43, D-34125 Kassel, Federal Republic of Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Double-Blind Method Electrocardiography* Female Fibrinolytic Agents / therapeutic use Heparin / therapeutic use Hirudin Therapy Humans Male Middle Aged Myocardial Infarction / drug therapy*, physiopathology Myocardial Reperfusion* Predictive Value of Tests Prospective Studies Statistics as Topic Streptokinase / therapeutic use Thrombolytic Therapy* Vascular Patency* |
| Chemical | |
Reg. No./Substance:
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0/Fibrinolytic Agents; 9005-49-6/Heparin; EC 3.4.-/Streptokinase |
| Comments/Corrections | |
Comment In:
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Eur Heart J. 2001 May;22(9):722-4
[PMID:
11350102
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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