Myocardial salvage after intracoronary thrombolysis with streptokinase in acute myocardial infarction

Journal Article · Thu Oct 01 00:00:00 EDT 1981 · N.Engl. J. Med.; (United States)

DOI:https://doi.org/10.1056/NEJM198110013051401· OSTI ID:5309986

Markis, J E; Malagold, M; Parker, J A; Silverman, K J; Barry, W H; Als, A V; Paulin, S; Grossman, W; Braunwald, E

Nine patients with acute myocardial infarction had cardiac catheterization and intracoronary infusions of streptokinase 2.3 to 4.3 hours (mean, 3.5) after the onset of symptoms. Occluded coronary arteries were opened within approximately 20 minutes in all patients, but reocclusion occurred in one patient. The immediate effect of thrombolysis on myocardial salvage was assessed with the intracoronary injection of thallium-201. Improved regional perfusion, indicating myocardial salvage after recanalization, was observed in seven of the nine patients. One patient, who had also sustained a nontransmural infarction one week before, had no change after thrombolysis. In the ninth patient, recanalization of a coronary artery was followed by reocclusion and worsening of the myocardial-perfusion defect. Intracoronary thallium-201 studies two weeks and three months after streptokinase infusion in two patients were unchanged in comparison with scintiscans performed 1.5 hours after thrombolysis. These short-term observations suggest that recanalization of obstructed coronary arteries after intracoronary thrombolysis can salvage jeopardized myocardium, However, evaluation of the long-term effects of this procedure on survival and myocardial function will require controlled clinical trials.

• OSTI ID: 5309986
• Journal Information: N.Engl. J. Med.; (United States), Journal Name: N.Engl. J. Med.; (United States) Vol. 305:14; ISSN NEJMA
• Country of Publication: United States
• Language: English

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59 BASIC BIOLOGICAL SCIENCES
62 RADIOLOGY AND NUCLEAR MEDICINE
ARTERIES
BETA DECAY RADIOISOTOPES
BIOLOGICAL EFFECTS
BLOOD VESSELS
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
CHEMOTHERAPY
CORONARIES
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSTIC TECHNIQUES
DIAGNOSTIC USES
DISEASES
DYNAMIC FUNCTION STUDIES
ELECTRON CAPTURE RADIOISOTOPES
ENZYMES
HEART
HEAVY NUCLEI
HYDROLASES
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MUSCLES
MYOCARDIAL INFARCTION
MYOCARDIUM
NUCLEI
ODD-EVEN NUCLEI
ORGANS
PATHOLOGY
PATIENTS
PEPTIDE HYDROLASES
RADIOISOTOPE SCANNING
RADIOISOTOPES
SCINTISCANNING
SECONDS LIVING RADIOISOTOPES
SH-PROTEINASES
STREPTOCOCCAL PROTEINASE
THALLIUM 201
THALLIUM ISOTOPES
THERAPY
USES