Ventricular function and infarct size: the Western Washington Intravenous Streptokinase in Myocardial Infarction Trial
The Western Washington Intravenous Streptokinase in Acute Myocardial Infarction Trial randomized 368 patients with symptoms and signs of acute myocardial infarction of less than 6 h duration to either conventional care or 1.5 million units of intravenous streptokinase. The mean time to randomization was 209 min and 52% of patients were randomized within 3 h of symptom onset. Quantitative, tomographic thallium-201 infarct size and radionuclide ejection fraction were measured at 8.2 +/- 7.5 weeks in 207 survivors who lived within a 100 mile radius of a centralized laboratory. Overall, infarct size as a percent of the left ventricle was 19 +/- 13% for control subjects and 15 +/- 13% for treatment patients (p = 0.03). For anterior infarction in patients entered within 3 h of symptom onset, infarct size was 28 +/- 13% in the control group versus 19 +/- 15% for the treatment group (p = 0.09). Left ventricular ejection fraction was 47 +/- 15% in the control versus 51 +/- 15% in the treatment group (p = 0.08). For anterior infarction of less than 3 h duration, the ejection fraction was 38 +/- 16% in the control versus 48 +/- 20% in the treatment group (p = 0.13). By statistical analysis incorporating the nonsurvivors, p values for all of these variables were less than or equal to 0.08. There was no benefit for patients with inferior infarction or for anterior infarction of greater than 3 h duration. It is concluded that intravenous streptokinase, when given within 3 h of symptom onset to patients with anterior infarction, reduces infarct size and improves ventricular function.
- Research Organization:
- Veterans Administration Medical Center, Seattle, WA (USA)
- OSTI ID:
- 7142804
- Journal Information:
- J. Am. Coll. Cardiol.; (United States), Journal Name: J. Am. Coll. Cardiol.; (United States) Vol. 11:4; ISSN JACCD
- Country of Publication:
- United States
- Language:
- English
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62 RADIOLOGY AND NUCLEAR MEDICINE
BETA DECAY RADIOISOTOPES
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSIS
DISEASES
DYNAMIC FUNCTION STUDIES
ELECTRON CAPTURE RADIOISOTOPES
ENZYMES
HEART
HEAVY NUCLEI
HYDROLASES
INJECTION
INTAKE
INTRAVENOUS INJECTION
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MYOCARDIAL INFARCTION
NUCLEI
ODD-EVEN NUCLEI
ORGANS
PATIENTS
PEPTIDE HYDROLASES
RADIOISOTOPE SCANNING
RADIOISOTOPES
SECONDS LIVING RADIOISOTOPES
SH-PROTEINASES
STREPTOCOCCAL PROTEINASE
THALLIUM 201
THALLIUM ISOTOPES
THERAPEUTIC USES
USES