Early intervention in acute myocardial infarction: significance for myocardial salvage of immediate intravenous streptokinase therapy followed by coronary angioplasty

Journal Article · Sat Feb 28 23:00:00 EST 1987 · J. Am. Coll. Cardiol.; (United States)

DOI:https://doi.org/10.1016/S0735-1097(87)80055-4· OSTI ID:6862986

Miller, H I; Almagor, Y; Keren, G; Chernilas, J; Roth, A; Eschar, Y; Shapira, I; Shargorodsky, B; Berenfeld, D; Laniado, S

Sixteen patients with acute myocardial infarction underwent treatment with streptokinase up to 3 hours after the onset of chest pain. Nine patients (group I) received streptokinase within 1 hour of the onset of pain, and seven patients (group II) received it within 2 to 3 hours. All underwent multigated radionuclide ventriculography after streptokinase therapy and 1 week later. Percutaneous transluminal coronary angioplasty of the infarct artery was performed within 24 hours in all patients. An effort-limited treadmill stress test was performed before discharge. There was no mortality or serious complication. Mean peak total creatine kinase was 521 +/- 289 mU/ml in group I, and 1,614 +/- 709 mU/ml in group II (p less than 0.05). The mean initial left ventricular ejection fraction was 47 +/- 11% in group I and 37 +/- 10% in group II. After early angioplasty (within 24 hours) and at 1 week recovery, left ventricular ejection fraction increased to 53 +/- 9% in group I (p less than 0.05) and to 40 +/- 7% in group II (p = NS). Seven of the nine patients in group I had normal radionuclide ventriculograms at discharge compared with none of the seven patients in group II. Thrombolytic therapy administered less than 1 hour after the onset of symptoms of acute myocardial infarction followed by angioplasty of the infarct artery results in preservation of left ventricular function, whereas therapy given after 2 hours has only a limited effect.

• Research Organization: Tel-Aviv Medical Center, Israel
• OSTI ID: 6862986
• Journal Information: J. Am. Coll. Cardiol.; (United States), Journal Name: J. Am. Coll. Cardiol.; (United States) Vol. 3; ISSN JACCD
• Country of Publication: United States
• Language: English

Related Subjects

550600 -- Medicine
550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
ARTERIES
BLOOD VESSELS
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
CHEMOTHERAPY
COUNTING TECHNIQUES
DIAGNOSIS
DISEASES
ENZYMES
EXERCISE
HEART
HYDROLASES
MEDICINE
MYOCARDIAL INFARCTION
ORGANS
PATIENTS
PEPTIDE HYDROLASES
RADIOISOTOPE SCANNING
SH-PROTEINASES
STREPTOCOCCAL PROTEINASE
SURGERY
THERAPY