Document Detail


Prognostic markers in thrombolytic therapy: looking beyond mortality.
MedLine Citation:
PMID:  8990408     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In the era of multiple new therapies (e.g., aspirin, beta blockers, thrombolysis, angiotensin-converting enzyme inhibitors, etc.) with the potential to improve outcome, the utility of traditional methods for predicting risk for adverse outcome after acute myocardial infarction (MI) is being reevaluated. Recent data suggest that heart failure, male gender, older age, and ischemia on ambulatory electrocardiogram (ECG) monitoring are the best predictors for increased risk of death or nonfatal MI. Exercise stress testing and ejection fraction determination provide little, if any, additional prognostic information. A new, highly promising strategy is to assess the degree of resolution in ST-segment elevation on repeated ECG monitoring following thrombolytic therapy. Studies have shown that failure to achieve prespecified degrees of ST-segment resolution within the first few hours of thrombolytic therapy is a reliable indicator of risk for post-MI mortality. Emerging data are also raising the possibility that cardiac troponin-T levels can be utilized as an important prognostic marker for adverse outcome in patients who present with acute ischemic syndromes.
Authors:
C J Pepine
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The American journal of cardiology     Volume:  78     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1996 Dec 
Date Detail:
Created Date:  1997-02-06     Completed Date:  1997-02-06     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  24-7     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiovascular Medicine, University of Florida College of Medicine, Gainesville 32610, USA.
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Biological Markers / analysis
Cardiac Output, Low / complications
Electrocardiography / drug effects
Exercise Test
Female
Fibrinolytic Agents / therapeutic use*
Forecasting
Humans
Male
Myocardial Infarction / drug therapy,  mortality
Myocardial Ischemia / diagnosis
Prognosis
Risk Factors
Sex Factors
Stroke Volume
Survival Rate
Thrombolytic Therapy* / mortality
Treatment Outcome
Troponin / analysis
Troponin T
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Fibrinolytic Agents; 0/Troponin; 0/Troponin T

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


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