Document Detail

Prognostic significance of the extent of myocardial injury in acute myocardial infarction treated by streptokinase (the GISSI trial).
MedLine Citation:
PMID:  2658524     Owner:  NLM     Status:  MEDLINE    
To evaluate the different contributions of infarct site and infarct extent in determining the in-hospital outcome and efficacy of thrombolytic therapy, 8,731 patients with a first Q-wave acute myocardial infarction (AMI) enrolled in the GISSI trial were studied. On the basis of the standard 12-lead electrocardiogram, the sample was classified in 2 ways: classic electrocardiographic site pattern (anterior, inferior, lateral and multiple location), and number of standard electrocardiographic leads with ischemic ST elevation (small, modest, large and extensive infarct in 2 to 9 leads). In-hospital mortality was evaluated according to infarct site, infarct extent and fibrinolytic treatment. The mortality rate was differently distributed in the various infarct sites. Streptokinase significantly reduced mortality only in anterior (13.8 vs 18.7%) and multiple site infarcts (8.1 vs 12.5%). According to the infarct extent observed, there is a progressive increase in the mortality rate--from 6.5% in small infarcts to 9.6% in modest, 14.3% in large and 21.7% in extensive. No significant benefit was obtained by streptokinase in small infarcts; in contrast, a significant decrease in mortality was achieved in modest (7.7 vs 11.4%), large (12.8 vs 16.6%) and extensive infarcts (19.5 vs 23.9%). Thus, the extent of myocardial injury seems to be more relevant than the site in determining in-hospital mortality and efficacy of thrombolytic therapy.
F Mauri; M Gasparini; L Barbonaglia; E Santoro; M Grazia Franzosi; G Tognoni; F Rovelli
Related Documents :
2483224 - Acute consequences of ischemic myocardial damage.
11096674 - New thrombolytic agents: does direct angioplasty still have a role?
12642064 - Acute myocardial infarction.
8632624 - Accelerated st-segment reduction after thrombolytic therapy with recombinant tissue pla...
17284994 - Diagnosis of graft coronary artery disease.
20668004 - Mitochondria in heart failure.
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study    
Journal Detail:
Title:  The American journal of cardiology     Volume:  63     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1989 Jun 
Date Detail:
Created Date:  1989-06-28     Completed Date:  1989-06-28     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1291-5     Citation Subset:  AIM; IM    
De Gasperis Center, Milan, Italy.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Middle Aged
Multicenter Studies as Topic
Myocardial Infarction / diagnosis,  drug therapy*,  mortality
Random Allocation
Streptokinase / therapeutic use*
Reg. No./Substance:
EC 3.4.-/Streptokinase

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

Previous Document:  Interdependence of the left and right ventricles in health and disease.
Next Document:  Usefulness of penbutolol for systemic hypertension. Penbutolol Research Group.