Document Detail


Percutaneous transluminal coronary angioplasty, alone or in combination with streptokinase therapy, during acute myocardial infarction.
MedLine Citation:
PMID:  3159944     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The treatment strategy in 66 consecutive patients who underwent invasive therapy for acute myocardial infarction was analyzed, and specific attention was focused on the role of percutaneous transluminal coronary angioplasty. The following four treatment regimens were used: angioplasty alone (11 patients), angioplasty followed immediately by administration of streptokinase (15), streptokinase therapy alone (11), and streptokinase therapy followed by angioplasty (29). Reperfusion was achieved in 91%, 80%, 82%, and 72% of these subgroups, respectively. Angioplasty was particularly helpful in patients with severe residual stenoses after intracoronary administration of streptokinase and in patients in whom streptokinase therapy failed to reopen the occluded artery. Angioplasty further reduced the residual stenosis in 11 of 15 patients (73%) with successful thrombolysis, and it restored blood flow in 10 of 14 patients (71%) in whom thrombolysis had failed to do so. The incidence of reinfarction after therapy was similar in all four treatment groups. Patients in whom angioplasty was used either alone or in combination with streptokinase therapy had a significantly decreased incidence of subsequent revascularization (less than 30% compared with 82%). Angioplasty is of considerable value in patients undergoing invasive therapy for acute infarction. In some patients, it may be used as the only treatment; in others, it may be used to treat severe residual stenosis after initial streptokinase therapy. Finally, angioplasty achieves reperfusion in most patients in whom streptokinase therapy has failed.
Authors:
D R Holmes; H C Smith; R E Vlietstra; R A Nishimura; G S Reeder; A A Bove; J F Bresnahan; J H Chesebro; J M Piehler
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Mayo Clinic proceedings     Volume:  60     ISSN:  0025-6196     ISO Abbreviation:  Mayo Clin. Proc.     Publication Date:  1985 Jul 
Date Detail:
Created Date:  1985-08-19     Completed Date:  1985-08-19     Revised Date:  2013-12-13    
Medline Journal Info:
Nlm Unique ID:  0405543     Medline TA:  Mayo Clin Proc     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  449-56     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angiography
Angioplasty, Balloon*
Combined Modality Therapy
Coronary Circulation / drug effects
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Infarction / drug therapy,  therapy*
Streptokinase / administration & dosage,  therapeutic use*
Chemical
Reg. No./Substance:
EC 3.4.-/Streptokinase

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


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