Efficacy of a New Accelerated Streptokinase Regime in Acute Myocardial Infarction: A Double Blind Randomized Clinical Trial

Ghaffari, Samad; Kazemi, Babak; Golzari, Iraj Gorbani

doi:10.1111/j.1755-5922.2011.00284.x

Cited by 11 publications

(13 citation statements)

References 40 publications

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“…Mean pre-discharge EF was significantly higher in patients receiving accelerated SK regimen when compared to those who received traditional regimen (50.9 ± 6.6% versus 47.3 ± 4.6% respectively, P = 0.002), a result that is closely similar to that reported by Ghaffari et al 11 …”

Section: Discussionsupporting

confidence: 87%

“…Ghaffari et al 11 performed a randomized double-blind clinical trial comparing an accelerated infusion (1.5 MU/20 min) with the conventional infusion (1.5 MU/60 min) of SK in 300 patients with their first episode of acute STEMI. In multivariate analysis, accelerated SK infusion was the only independent predictor of higher coronary reperfusion (OR = 3.2, CI: 1.93-5.3, P < 0.001).…”

Section: Discussionmentioning

confidence: 99%

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Fibrinolytic therapy in patients with ST-segment elevation myocardial infarction: Accelerated versus standard Streptokinase infusion regimen

Bendary

Tawfik

Mahrous

et al. 2017

J Cardiovasc Thorac Res

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Introduction: Timely fibrinolysis for acute ST-segment elevation myocardial infarction (STEMI) reduces infarct size and hence preserves LV function and reduces mortality. Optimal regimen of streptokinase (SK) infusion in such patients is a matter of interest. The current study aimed to compare efficacy and safety of accelerated SK infusion regimen in patients with STEMI versus the standard one. Methods: One hundred consecutive STEMI patients were randomly allocated into one of 2 groups: group I (50 patients) who received accelerated SK regimen (1.5 million units over 30 minutes) and group II (50 patients) received standard SK regimen (1.5 million units over 60 minutes). Efficacy was evaluated non-invasively using clinical (chest pain), ECG (resolution of ST segment) and laboratory tests (earlier and higher peaking of cardiac troponin I). Safety was evaluated by assessment of multiple in-hospital adverse events. Results: Both groups were statistically matched in all baseline criteria. There was a significant difference between both groups regarding each parameter of successful reperfusion in favor of accelerated regimen. When all these parameters were combined, 31 patients (62%) had successful reperfusion in group I versus 19 patients (38%) in group II (P = 0.016). We did not report any significant difference between both groups regarding in-hospital mortality, in-hospital heart failure, major bleeding, hypotension or allergic reaction to SK. Mean pre-discharge ejection fraction was higher in group I than group II (50.9 ± 6.6% versus 47.3 ± 4.6%, P = 0.002). Conclusion: Accelerated regimen of SK infusion is safe and effective method of reperfusion in patients with STEMI.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Fibrinolytic therapy in patients with ST-segment elevation myocardial infarction: Accelerated versus standard Streptokinase infusion regimen

Bendary

Tawfik

Mahrous

et al. 2017

J Cardiovasc Thorac Res

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“…TLT-related complications were recorded for each patient. Previously, we showed that transient hypotension during streptokinase infusion is readily corrected by concomitant rapid saline infusion in almost all patients [16], so, we did not consider this reaction as a complication during the present study. Other concomitant therapies were permitted at the discretion of the managing physician.…”

Section: Tlt Regimenmentioning

confidence: 85%

The Effect of Prethrombolytic Cyclosporine‐A Injection on Clinical Outcome of Acute Anterior ST‐Elevation Myocardial Infarction

Ghaffari

Kazemi

Toluey

et al. 2013

Cardiovascular Therapeutics

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SUMMARYIntroduction: Reperfusion injury reduces the benefits of early reperfusion therapies after acute ST-elevation myocardial infarction (STEMI). Cyclosporine-A (CsA) is a potent inhibitor of opening of the mitochondrial permeability transition pore, which has been shown to play a key role in myocardial reperfusion injury. The impact of this treatment on clinical outcomes of acute STEMI remains unknown. Our aim was to investigate the clinical outcomes of using this drug in patients with acute anterior STEMI receiving thrombolytic treatment (TLT). Methods: In this double-blinded randomized clinical trial, 101 patients with acute anterior STEMI who were candidate for TLT, were enrolled and randomly assigned into treatment or control groups. Patients in the treatment group received an intravenous bolus injection of 2.5 mg/kg of CsA immediately before TLT. The patients in the control group received an equivalent volume of normal saline. Infarct size, occurrence of major arrhythmias, heart failure, left ventricular ejection fraction (LVEF), TLT-related complications, in-hospital and 6-month mortality rates were investigated. Results: There were no significant differences among the demographics, myocardial enzyme release, occurrence of major arrhythmias [9 (18%) vs. 12 (23.5%), P = 0.80], heart failure [18 (36%) vs. 19 (38.3%), P = 0.83], LVEF at first day [34.7 ± 9.9% vs. 33.5 ± 8.1%, P = 0.50] or at discharge [37.7 ± 10% vs. 36.1 ± 8.2%, P = 0.43], and in-hospital [4 (8%) vs. 6 (11.8%), P = 0.74] or 6-month mortality rates [9 (18%) vs. 10 (19.6%), P = 0.99] between the CsA vs. the control group. Conclusion: In this study, the prethrombolytic administration of CsA was not associated with a reduction in the infarct size or any improvement in clinical outcomes.

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“…The efficacy and safety of this regimen has been previously shown [16]. Additionally, they received acetyl salicylic acid 300 mg, clopidogrel 300 mg to 600 mg orally, unfractionated or low molecular weight heparin, and statins.…”

Section: Thrombolytic Treatmentmentioning

confidence: 99%

Mean platelet volume is a predictor of ST resolution following thrombolysis in acute ST elevation myocardial infarction

Ghaffari

Pourafkari

Javadzadegan

et al. 2015

Thrombosis Research

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Efficacy of a New Accelerated Streptokinase Regime in Acute Myocardial Infarction: A Double Blind Randomized Clinical Trial

Abstract: SUMMARYBackground: Studies of thrombolysis in acute ST-elevation myocardial infarction (STEMI)

Cited by 11 publications

References 40 publications

Fibrinolytic therapy in patients with ST-segment elevation myocardial infarction: Accelerated versus standard Streptokinase infusion regimen

Fibrinolytic therapy in patients with ST-segment elevation myocardial infarction: Accelerated versus standard Streptokinase infusion regimen

The Effect of Prethrombolytic Cyclosporine‐A Injection on Clinical Outcome of Acute Anterior ST‐Elevation Myocardial Infarction

Mean platelet volume is a predictor of ST resolution following thrombolysis in acute ST elevation myocardial infarction

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