Late streptokinase infusion and antithrombotic treatment in myocardial infarction reduce subsequent myocardial ischemia

Grip, Lars; Rydén, Lars

doi:10.1016/0002-8703(91)90183-i

Cited by 9 publications

(2 citation statements)

References 17 publications

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“…Accordingly, the time span within which thrombolysis is effective 122 Mickley/Junker/Mollcr Thrombolysis and Postinfarction Myocardial Ischemia seems less well defined. The effects of late thrombolytic therapy on postinfarction isch emia has been investigated by Grip and Ryden [17]. One hundred and eleven patients eli gible for late thrombolysis (> 12 h) were ran domly assigned to streptokinase including subsequent antithrombotic drugs (treatment group) and routine treatment (control group).…”

Section: Thrombolysis and Postinfarction Myocardial Ischemiamentioning

confidence: 99%

“…Peak values of heart rate or blood pressure and maximal exercise capacity are other stress test variables of diagnostic and prognostic significance. Various recent reports have suggested that thrombolytic ther apy improves one or more of these hemody namic exercise variables [9,12,14,17,24], 123 The mechanisms underlying these observa tions are unknown but may to some extent be the result of better preserved left ventricular function in thrombolysed patients. A lower prevalence of residual ischemia among reper fused patients is proposed to be another factor of pathophysiological importance [14.…”

Section: Thrombolysis and Hemodynamic Exercise Test Variablesmentioning

confidence: 99%

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Effect of Thrombolytic Therapy on Postinfarction Myocardial Ischemia

Mickley

Junker²,

Møller³

1994

Cardiology

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In patients with acute myocardial infarction a substantial reduction in mortality can be achieved by early intravenous thrombolytic therapy. The beneficial effect of thrombolysis on left ventricular function is relatively small, and it seems unlikely that this minor improvement alone can be responsible for the reduction in cardiac death. So far it has not been clearly established how thrombolytic therapy affects postinfarction myocardial ischemia. From studies evaluating ST segment changes on exercise testing or ambulatory monitoring it is concluded that thrombolysis probably results in a reduction of residual ischemia. The reduced ischemic burden is proposed to be one important pathophysiological mechanism underlying the frequently observed improvement in hemodynamic stress test variables following thrombolytic treatment.

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Section: Thrombolysis and Postinfarction Myocardial Ischemiamentioning

confidence: 99%

Section: Thrombolysis and Hemodynamic Exercise Test Variablesmentioning

confidence: 99%

Effect of Thrombolytic Therapy on Postinfarction Myocardial Ischemia

Mickley

Junker²,

Møller³

1994

Cardiology

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Thrombolytic Agents: Lessons for Their Use in Acute Stroke from Myocardial Infarction Experience

Verstraete

1993

Thrombolytic Therapy in Acute Ischemic Stroke II

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Thallium and indium antimyosin dual-isotope single-photon emission tomography in acute myocardial infarction to identify patients at further ischaemic risk

Schoeder

Topp²,

Friedrich³

et al. 1994

Eur J Nucl Med

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Dual-isotope single-photon emission tomography (SPET) with indium-111 antimyosin and thallium-201 chloride was performed in 54 patients with acute myocardial infarction (AMI) to detect the location and extent of myocardial necrosis (antimyosin) and viable myocardium (201Tl). All patients underwent intravenous thrombolytic therapy with either streptokinase (1.5 million units/90 min) or tissue plasminogen activator (80 mg/90 min). Sensitivity in detecting MI was 91% (49/54 patients). With regard to dual-isotope SPET patterns, patients were divided into three groups: match, i.e. antimyosin uptake in segments with thallium defect (n = 8); mismatch, i.e. no uptake of either of the nuclides in corresponding segments (presence of perfusion abnormalities in the absence of antimyosin uptake) (n = 5); and overlap, i.e. thallium uptake in segments with uptake of antimyosin (n = 41). Coronary angiography and thallium exercise tests were performed in 40 and 45 patients, respectively, 5-14 days after MI. Exercise-induced ischaemia occurred in 66% of patients with overlap, 14% with match and 0% with mismatch (P < 0.05 for overlap vs other groups). If, however, major in-hospital complications (sudden cardiac death, severe arrhythmias; five overlap, three overlap in addition to match/mismatch, two match, two mismatch) were included in the statistical analysis, there was no significant difference between the three groups (P = NS). Thus, although the dual-isotope pattern "overlap" identifies a subgroup of patients with a substantial amount of residual viable tissue after MI and a high probability of exercise-induced ischaemia, this criterion is of limited value in assessing short-term prognosis.(ABSTRACT TRUNCATED AT 250 WORDS)

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Late streptokinase infusion and antithrombotic treatment in myocardial infarction reduce subsequent myocardial ischemia

Cited by 9 publications

References 17 publications

Effect of Thrombolytic Therapy on Postinfarction Myocardial Ischemia

Effect of Thrombolytic Therapy on Postinfarction Myocardial Ischemia

Thrombolytic Agents: Lessons for Their Use in Acute Stroke from Myocardial Infarction Experience

Thallium and indium antimyosin dual-isotope single-photon emission tomography in acute myocardial infarction to identify patients at further ischaemic risk

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