Document Detail


Rapid resolution of ST elevation and prediction of clinical outcome in patients undergoing thrombolysis with alteplase (recombinant tissue-type plasminogen activator): results of the Israeli Study of Early Intervention in Myocardial Infarction.
MedLine Citation:
PMID:  2121199     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Alteplase (recombinant tissue-type plasminogen activator (rt-PA)) was infused within four hours of onset of symptoms in 286 patients with acute myocardial infarction. Delayed coronary angiography was performed 72 hours after admission with coronary angioplasty if indicated. Electrocardiographic monitoring was continuous during the first hour of treatment. The sum of the ST segment elevations (sigma ST) was calculated on electrocardiograms recorded at entry and an hour later. ST elevations resolved rapidly within one hour of treatment in 189 patients and persisted in 97 patients. Rapid resolution of ST elevation correlated with angiographic coronary patency as determined by coronary angiography 72 hours after admission. The patients with rapid resolution of sigma ST had significantly smaller infarcts and a better clinical outcome than the patients with persistent ST elevation. sigma ST values at entry and one hour after treatment had no additional independent predictive value. Rapid resolution of ST elevations in patients undergoing thrombolysis with alteplase was associated with a significantly smaller release of creatine kinase, better preservation of left ventricular function, lower morbidity, and less short and long term mortality. Rapid resolution of sigma ST elevation is an efficient indicator of clinical outcome in groups of patients with acute myocardial infarction undergoing thrombolysis with alteplase.
Authors:
G I Barbash; A Roth; H Hod; H I Miller; S Rath; Y Har-Zahav; M Modan; U Seligsohn; A Battler; E Kaplinsky
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  British heart journal     Volume:  64     ISSN:  0007-0769     ISO Abbreviation:  Br Heart J     Publication Date:  1990 Oct 
Date Detail:
Created Date:  1990-12-10     Completed Date:  1990-12-10     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0370634     Medline TA:  Br Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  241-7     Citation Subset:  AIM; IM    
Affiliation:
Cardiology Department, Sheba Medical Center, Tel Hashomer, Israel.
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MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Angiography
Creatine Kinase / blood
Electrocardiography / drug effects
Female
Humans
Israel
Male
Middle Aged
Myocardial Infarction / drug therapy*,  enzymology,  mortality
Predictive Value of Tests
Recombinant Proteins
Thrombolytic Therapy*
Time Factors
Tissue Plasminogen Activator / therapeutic use*
Chemical
Reg. No./Substance:
0/Recombinant Proteins; EC 2.7.3.2/Creatine Kinase; EC 3.4.21.68/Tissue Plasminogen Activator
Comments/Corrections

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