BACKGROUND: Restoration of infarct vessel patency is the key treatment for acute ST-elevation myocardial infarction. OBJECTIVE: The purpose of the study was to confirm the effectiveness of streptokinase (STK) for successful thrombolysis of the infarct-related artery (IRA) in patients with acute myocardial infarction (AMI), in relation to the time of the index event and age compared with newer thrombolytic agents, in a tertiary care centre. METHODS: 100 patients (77% male) thrombolysed with STK underwent coronary angiography within 48 h of presentation. Patency of the IRA was used to assess successful thrombolysis. RESULTS: The mean pain-to-needle time was 3.24 h. 76 patients (76%) treated with thrombolysis had patent arteries with thrombolysis in myocardial infarction (TIMI) 2 or 3 flow. In subgroup analysis of time from the index event, patency rates were 83.3%, 77.5%, 68.7% and 40% in patients presenting within 0-2, 2-4, 4-6 and 6-12 h, respectively. In subgroup analysis, all patients less than 30 years of age had patent arteries with TIMI 2 or 3 flow. Coronary angiography showed the IRA was the left anterior descending artery (LAD) in 55%, the right coronary artery (RCA) in 33% and the left circumflex artery (LCX) in 12%. The patency rates of the LAD, RCA and LCX were 74.5%, 69.6% and 100%, respectively. CONCLUSIONS: We found STK to be as effective as newer thrombolytic agents reported in other studies. In patients with AMI thrombolysed within 4 h, STK results in higher patency in young compared to older patients.
BACKGROUND: Restoration of infarct vessel patency is the key treatment for acute ST-elevation myocardial infarction. OBJECTIVE: The purpose of the study was to confirm the effectiveness of streptokinase (STK) for successful thrombolysis of the infarct-related artery (IRA) in patients with acute myocardial infarction (AMI), in relation to the time of the index event and age compared with newer thrombolytic agents, in a tertiary care centre. METHODS: 100 patients (77% male) thrombolysed with STK underwent coronary angiography within 48 h of presentation. Patency of the IRA was used to assess successful thrombolysis. RESULTS: The mean pain-to-needle time was 3.24 h. 76 patients (76%) treated with thrombolysis had patent arteries with thrombolysis in myocardial infarction (TIMI) 2 or 3 flow. In subgroup analysis of time from the index event, patency rates were 83.3%, 77.5%, 68.7% and 40% in patients presenting within 0-2, 2-4, 4-6 and 6-12 h, respectively. In subgroup analysis, all patients less than 30 years of age had patent arteries with TIMI 2 or 3 flow. Coronary angiography showed the IRA was the left anterior descending artery (LAD) in 55%, the right coronary artery (RCA) in 33% and the left circumflex artery (LCX) in 12%. The patency rates of the LAD, RCA and LCX were 74.5%, 69.6% and 100%, respectively. CONCLUSIONS: We found STK to be as effective as newer thrombolytic agents reported in other studies. In patients with AMI thrombolysed within 4 h, STK results in higher patency in young compared to older patients.
Authors: P G Steg; T Laperche; J L Golmard; J M Juliard; H Benamer; D Himbert; P Aubry Journal: J Am Coll Cardiol Date: 1998-03-15 Impact factor: 24.094
Authors: Philippe Lachance; Jean-Pierre Déry; Jonathan Beaudoin; G Erald Barbeau; Bernard Noël; Olivier F Bertrand; Josep Rodés-Cabau; Can M Nguyen; Guy Proulx; Onil Gleeton; Eric Larose; Louis Roy; Robert Delarochelliére Journal: J Invasive Cardiol Date: 2008-11 Impact factor: 2.022
Authors: W Merx; R Dörr; P Rentrop; H Blanke; K R Karsch; D G Mathey; P Kremer; W Rutsch; H Schmutzler Journal: Am Heart J Date: 1981-12 Impact factor: 4.749