Document Detail

Thrombolysis significantly reduces transient myocardial ischaemia following first acute myocardial infarction.
MedLine Citation:
PMID:  1600986     Owner:  NLM     Status:  MEDLINE    
In order to investigate whether thrombolysis affects residual myocardial ischaemia, we prospectively performed a predischarge maximal exercise test and early out-of-hospital ambulatory ST segment monitoring in 123 consecutive men surviving a first acute myocardial infarction (AMI). Seventy-four patients fulfilled our criteria for thrombolysis, but only the last 35 patients included received thrombolytic therapy. As thrombolysis was not available in our Department at the start of the study, the first 39 patients included were conservatively treated (controls). No significant differences in baseline clinical characteristics were found between the two groups. In-hospital atrial fibrillation and digoxin therapy was more prevalent in controls (P less than 0.05). During exercise, thrombolysed patients reached a higher maximal work capacity compared with controls: 160 +/- 41 vs 139 +/- 34 W (P less than 0.02). Thrombolysis resulted in a non-significant reduction in exercise-induced ST segment depression: prevalence 43% vs 62% in controls. However, during ambulatory monitoring the duration of transient myocardial ischaemia was significantly reduced in thrombolysed patients: 322 min vs 1144 min in controls (P less than 0.05). Thrombolysed patients reached a higher heart rate during transient ischaemic episodes: 114 +/- 17 vs 93 +/- 11 b.min-1 in controls (P less than 0.001). In conclusion, thrombolytic therapy administered for a first AMI significantly reduces the burden of transient myocardial ischaemia. This may explain the improvement in myocardial function during physical activities, which was also observed in this study.
H Mickley; P Pless; J R Nielsen; J Berning; M Møller
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European heart journal     Volume:  13     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  1992 Apr 
Date Detail:
Created Date:  1992-07-14     Completed Date:  1992-07-14     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  484-90     Citation Subset:  IM    
Department of Cardiology, Odense University Hospital, Denmark.
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MeSH Terms
Coronary Circulation / drug effects*,  physiology
Coronary Disease / drug therapy*,  physiopathology
Electrocardiography, Ambulatory / drug effects*
Exercise Test / drug effects*
Hemodynamics / drug effects,  physiology
Infusions, Intravenous
Myocardial Contraction / drug effects,  physiology
Myocardial Infarction / drug therapy*,  physiopathology
Prospective Studies
Retrospective Studies
Thrombolytic Therapy / methods*
Erratum In:
Eur Heart J 1992 Jul;13(7):1009

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

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