TY - JOUR
T1 - Intracoronary thrombolysis 3 to 13 days after acute myocardial infarction for postinfarction angina pectoris
AU - Shapiro, Edward P.
AU - Brinker, Jeffrey A.
AU - Gottlieb, Sidney O.
AU - Guzman, Pablo A.
AU - Bulkley, Bernadine H.
N1 - Funding Information:
From the Diviiion of Cardiology, Deparbnent of Medicine, Johns Hopkins Hospital, and the Division of Cardiology, Department of Medicine, Francis Scott Key Medical Center, Baltimore, Maryland. This study was supported by lschemic Heart Disease Specialized Center for Research &ant PXU-lL-17655-05 and Training &ant 5-T3 2-HL-07227 from the National lnstiies of Health, Bethesda, Maryland; and The Peter Belfer Laboratory for Myocardial Research, Baltimore, Maryland. Manuscript received December 17, 1984; revised manuscript received February 14, 1985, accepted February 18,1985. Address for reprints: dward P. Shapiro, MD, Division of Cardiilogy, Francis Scott Key Medi Es I Center, 4940 Eastern Avenue. Baltimore. Maryland 21224..
PY - 1985/6/1
Y1 - 1985/6/1
N2 - The restoration of anterograde coronary flow long after coronary thrombosis may be of benefit to patients with continuing ischemia. To determine whether "old" intracoronary thrombi are susceptible to lysis with thrombolytic agents, 18 patients with angina at rest during evolving acute myocardial infarction (AMI) and total occlusion of the infarct vessel were treated with Intracoronary streptokinase 3 to 13 days after onset of AMI. In 12 of the 18 patients (67%), successful recanalization of the artery was achieved 6.9 ± 2.7 days after AMI. Thrombolysis was followed by coronary angioplasty in 2 patients. To evaluate the efficacy of this approach in reducing post-AMI Ischemia, the number of episodes of angina at rest was compared in patients with successful and unsuccessful attempts at recanalization. Even in patients without angioplasty, the mean number of daily episodes decreased from 1.02 ± 0.6 to 0.09 ± 0.2 in patients In whom reperfusion was achieved, and from 1.07 ± 0.8 to 0.88 ± 0.8 in those in whom it was not (p = 0.027 for the difference between the groups). Thus, in patients with early post-AMI angina, intracoronary streptokinase can restore flow in the occluded artery, may decrease the frequency of angina, and allows angioplasty to be performed.
AB - The restoration of anterograde coronary flow long after coronary thrombosis may be of benefit to patients with continuing ischemia. To determine whether "old" intracoronary thrombi are susceptible to lysis with thrombolytic agents, 18 patients with angina at rest during evolving acute myocardial infarction (AMI) and total occlusion of the infarct vessel were treated with Intracoronary streptokinase 3 to 13 days after onset of AMI. In 12 of the 18 patients (67%), successful recanalization of the artery was achieved 6.9 ± 2.7 days after AMI. Thrombolysis was followed by coronary angioplasty in 2 patients. To evaluate the efficacy of this approach in reducing post-AMI Ischemia, the number of episodes of angina at rest was compared in patients with successful and unsuccessful attempts at recanalization. Even in patients without angioplasty, the mean number of daily episodes decreased from 1.02 ± 0.6 to 0.09 ± 0.2 in patients In whom reperfusion was achieved, and from 1.07 ± 0.8 to 0.88 ± 0.8 in those in whom it was not (p = 0.027 for the difference between the groups). Thus, in patients with early post-AMI angina, intracoronary streptokinase can restore flow in the occluded artery, may decrease the frequency of angina, and allows angioplasty to be performed.
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U2 - 10.1016/0002-9149(85)90952-X
DO - 10.1016/0002-9149(85)90952-X
M3 - Article
C2 - 4003287
AN - SCOPUS:0021823905
SN - 0002-9149
VL - 55
SP - 1453
EP - 1458
JO - The American journal of cardiology
JF - The American journal of cardiology
IS - 13
ER -