Document Detail


Thrombolytic therapy for acute myocardial infarction-effects, problems and strategies.
MedLine Citation:
PMID:  7699735     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The effects and problems of coronary thrombolysis (CT) were investigated in 652 patients with initial acute myocardial infraction (AMI). Nosocomial mortality obtained by matching factors which determined prognosis was significantly lower in patients treated by CT (8.3%) than in those who did not undergo CT (18.1%). Regardless of whether the treatment was intracoronary arterial (ICT) or intravenous (IVCT), the primary cause of the decreased mortality was reperfusion of the coronary artery responsible for infarction (mortality 6.1% in the reperfused group vs 21.5% in the ineffective group). CT therapy improved left ventricular ejection fraction (LVEF), the nosocomial mortality rate, and regional wall motion at the site of infarction in cases that were reperfused less than 3 h, 3-6 h, and even 6 or more hours after the therapy. The long-term prognosis was significantly better in the reperfused group than in the ineffective group for 5 years and 7 months after therapy. However, CT was accompanied by both (1) poor prognosis in the ineffective group; and (2) unfavorable effects on the prognosis and on the daily life of patients with severe stenosis even after treatment. Accordingly, supplemental ICT and rescue PTCA (strategy (A)) were performed to treat the first problem, and deferred PTCA (strategy (B)) was conducted to treat the second problem in 80 patients with initial AMI. As a result, strategy (A) increased the coronary reperfusion rate to 94.3%, and strategies (A) and (B) together decreased the nosocomial mortality rate of 8.5% to 3.8%, and reduced the risk of death by 55.3%.
Authors:
K Nagao; K Kanmatsuse; N Kajiwara
Related Documents :
3443985 - Short-term inhibition of cardiac cellular autophagy by isoproterenol.
2138525 - Ventricular remodeling after myocardial infarction. experimental observations and clini...
10451865 - Comparison of parameters of 123i-mibg scintigraphy for predicting prognosis in patients...
24105865 - Left ventricular mass regression after sutureless implantation of the perceval s aortic...
6842355 - Microprocessor-based long term cardiorespirography. i. heart rate changes and apneic at...
3119685 - Community hospital administration of intravenous tissue plasminogen activator in acute ...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Japanese circulation journal     Volume:  58     ISSN:  0047-1828     ISO Abbreviation:  Jpn. Circ. J.     Publication Date:  1994 Dec 
Date Detail:
Created Date:  1995-05-04     Completed Date:  1995-05-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7806868     Medline TA:  Jpn Circ J     Country:  JAPAN    
Other Details:
Languages:  eng     Pagination:  885-93     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Surugadai Nihon Unversity Hospital, Tokyo, Japan.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Humans
Myocardial Infarction / drug therapy*
Myocardial Reperfusion
Prognosis
Recurrence
Thrombolytic Therapy* / methods,  mortality
Treatment Outcome

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


Previous Document:  Relationship between characteristics of endocardial electrograms and regional wall motion abnormalit...
Next Document:  Effect of ischemic preconditioning on ischemia-induced contractile failure and accumulation of extra...