1984
DOI: 10.1161/01.cir.70.4.606
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A randomized trial of intravenous and intracoronary streptokinase in patients with acute myocardial infarction.

Abstract: The clinical effects of intravenous streptokinase in patients with acute myocardial infarction were compared with those of intracoronary streptokinase in a randomized, prospective study. Comparisons were also made with a historical control group. Fifty patients were entered into the study at 2.4 + 1.2 hr after onset of pain, and 27 were assigned to intravenous and 23 to intracoronary therapy. The doses of streptokinase averaged 212,000 U ic and 845,000 U iv (0.75 x 106 U/5 hr, n = 14 or 106 U/1 hr, n = 13). Re… Show more

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Cited by 132 publications
(32 citation statements)
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“…Acute recanalization either failed to occur or was inadequate by the criteria above in 22 of 44 (50%) of our patients who received intracoronary streptokinase, in 15 of 32 (47%) patients studied by Sheehan et al,40 and in at least 43 of 77 (56%) studied by Harrison et al 21 The pessimistic interpretation of these data is that intracoronary streptokinase appears to be relatively ineffective in almost half of patients with acute transmural myocardial infarction. Such patients would require percutaneous angioplasty4' or bypass surgery42 to achieve satisfactory acute reperfusion.…”
Section: Discussionmentioning
confidence: 56%
“…Acute recanalization either failed to occur or was inadequate by the criteria above in 22 of 44 (50%) of our patients who received intracoronary streptokinase, in 15 of 32 (47%) patients studied by Sheehan et al,40 and in at least 43 of 77 (56%) studied by Harrison et al 21 The pessimistic interpretation of these data is that intracoronary streptokinase appears to be relatively ineffective in almost half of patients with acute transmural myocardial infarction. Such patients would require percutaneous angioplasty4' or bypass surgery42 to achieve satisfactory acute reperfusion.…”
Section: Discussionmentioning
confidence: 56%
“…[1][2][3][4][5][6][7][8][9] In most recent studies, intravenous streptokinase has been administered rapidly so as to achieve a high concentration of streptokinase in proximity to the coronary thrombus and thereby accelerate thrombolysis. '0- '3 One limitation of the administration of a rapid intravenous infusion of streptokinase is that it can cause a significant fall in systemic blood pressure.4' 5' This study investigates the frequency and severity of the hypotensive effect of intravenous infusion of streptokinase in patients with acute myocardial infarction and its relationship to the rate of the infusion.…”
mentioning
confidence: 99%
“…D, shadedzones represent the 10th to the 90th percentile area of CREF values in normal persons. On the x axis, the CREF values of the anterior and inferoposterior wall areas are displayed (%), while on they axis the segment numbers of the anterior wall (I-IO) and of the inferoposterior wall (11)(12)(13)(14)(15)(16)(17)(18)(19)(20) 'p <0.05; tp <O.OOl. CREF = contribution to regional ejection fraction (see Figure 1).…”
Section: Methodsmentioning
confidence: 99%