Die Kurzzeitfibrinolyse beim akuten Myokardinfarkt

Breddin, K; Am, Ehrly; Fechler, L; Frick, David N.; König, H.; Kraft, Hermine; Krause, H. R.; Hj, Krzywanek; Kutschera, J.; Hw, Losch; Ludwig, Oliver; Mikat, Barbara; Rausch, F; Rosenthal, Paul; Sartory, S; Voigt, Günter; Wylicil, P

doi:10.1055/s-0028-1106921

Cited by 63 publications

(8 citation statements)

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“…A subsample of the patients studied by the 11. German-Swiss group (Gillmann et al, 1973), the Second European Working Party (1971) and the Frankfurt study group (Breddin et al, 1973) were also admitted to a coronary care unit; the reduction in hospital mortality observed in this subset of the total group was not statiscally significant which is in line with the conclusion of the four multicentre trials in which all patients were admitted in a coronary care unit.…”

Section: Discussionmentioning

confidence: 65%

“…The Frankfurt study is a multicentre trial in which patients with an acute myocardial infarction of less than 12 hours duration were given a short-term streptokinase infusion for 3 hours (Breddin et al, 1973). A significant decreased in-hospital mortality rate of the streptokinase group was observed but only for the patients admitted to general wards.…”

Section: Discussionmentioning

confidence: 99%

“…It is recognised, however, that there is no certainty about the optimal dosage. The beneficial effect of a short-term intensive course of 750,000 units of streptokinase administered in 3 hours as demonstrated by Breddin et al (1973), appears to be an interesting approach still to be confirmed. Heparin in the present trial was not used as there is no evidence that in patients with acute myocardial infarction heparin preceding coumarin is superior to coumarin alone and the value of heparinisation of patients with recent myocardial infarction has been challenged (Brown et al, 1965).…”

Section: Treatmentmentioning

confidence: 96%

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Streptokinase in Acute Myocardial Infarction Extended Report of the European Cooperative Trial

1981

Journal of Internal Medicine

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Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 96%

See 1 more Smart Citation

Streptokinase in Acute Myocardial Infarction Extended Report of the European Cooperative Trial

1981

Journal of Internal Medicine

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“…Most of these studies have used a low-dose protocol with a loading dose of 0.25 million units, followed by a prolonged infusion over 12 to 24 hours [99][100][101][102][103][104][105][106][107][108][109]112,113,115]. The time between onset of symptoms and treatment has been variable; therapy was usually initiated less than six hours after onset of symptoms; in three trials [94][95][96][97], however, patients were treated more than 24 hours after onset of symptoms.…”

Section: Intravenous Streptokinasementioning

confidence: 99%

Analytic Review: Thrombolytic Therapy in Acute Myocardial Infarction

Zwerner

Gore

1986

J Intensive Care Med

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The salvage of myocardium in the setting of acute myocardial infarction has long been a goal of physicians involved in the care of patients with coronary artery disease. Understanding the role of thrombosis in the pathogenesis of acute myocardial infarction has led the way to an entirely new approach to the treatment of this entity. Thrombolytic therapy has now become a widely used form of treatment with encouraging results. Both intravenous and intracoronary administration of thrombolytic agents have been shown to promote recanalization of acutely occluded coronary arteries. Results of studies using the clot-specific agent, tissue plasminogen activator, intravenously have been most encouraging; successful reperfusion has been obtained in approximately 70% of patients treated. In addition, a recent large-scale trial has shown a reduction in morbidity and mortality with the early use of thrombolytic agents.Ongoing trials should help delineate the precise role and timing of these agents as the initial form of therapy for acute myocardial infarction. Other issues that remain unresolved are the frequency of restenosis and the role of percutaneous transluminal coronary angioplasty in addition to thrombolytic therapy in the treatment of acute myocardial infarction.Coronary heart disease is the leading cause of death in the United States; over one-half million individuals die from it each year. Between 5 and 6 million Americans have chronic, symptomatic coronary artery disease. In 1983, over 680,000 individuals were hospitalized with myocardial infarction [1]. J.The medical management of myocardial infarction has evolved gradually over the past 30 years, from a strategy of permitting the heart to heal by putting the patient and the heart to rest to increasingly more active monitoring in coronary care units with aggressive treatment of identified abnormalities. It is uncommon for a patient with myocardial infarction to die of a primary rhythm disturbance in the acute phases of infarction [2]. Today, extensive myocardial injury is the most common cause of death and morbidity among patients hospitalized with acute myocardial infarction (AMI) [1]. Massive myocardial ischemia produces pump failure and serious ventricular arrhythmias [3]. Thus, shortterm survival is intimately related to the size of myocardial infarction; loss of more than 40% of the left ventricular (LV) myocardium almost always results in death. The risk of death appears to decrease with decreasing infarct size.Methods to reduce the extent and severity of myocardial damage have therefore been sought. Myocardial damage results from the disparity between oxygen demand and delivery in ischemic tissue. To limit infarct size, one can attempt to reduce myocardial oxygen demands or improve myocardial oxygen supply. Attempts to limit infarct size and improve early survival in AMI by pharmacologically decreasing myocardial oxygen demands have been disappointing [4][5][6]. Beta blockers have been shown to improve long-term survival when used prophylactically [7,8], a...

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“…Although the Austrian study 230 showed the lowest mortality among patients treated with SK in coronary care units and the highest in a control group treated on general wards, trials performed exclusively in coronary care units 218 ' 218220232 " 235 reported no difference in mortality between treated and control groups. In the Frankfurt study, 229 the benefit from SK treatment in general wards equaled that in coronary care units. However, no difference was found between control patients on general wards or in coronary care units.…”

Section: Thrombolytic Therapymentioning

confidence: 99%