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Calcium-channel blockers as adjuvant therapy postthrombolysis
1Cardiology Section, Department of Veterans Affairs Medical Center, Boston, Massachusetts 02130.
Journal of Cardiovascular Pharmacology
|January 1, 1991
Summary
Successful thrombolytic therapy for acute myocardial infarction can lead to an incomplete infarction. This review explores similarities with non-Q-wave infarction and discusses calcium-channel blockers as adjunctive therapy.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Successful thrombolytic therapy for acute myocardial infarction (AMI) alters transmural necrosis, leading to an incomplete infarction.
- This salvaged myocardium is often associated with a patent but stenotic infarct-related artery, resembling non-Q-wave infarction.
Purpose of the Study:
- To review features shared between naturally occurring non-Q-wave infarction and successfully reperfused AMI.
- To address the role of adjunctive pharmacologic therapy, specifically calcium-channel blockers, in managing incomplete infarction post-thrombolysis.
Main Methods:
- Review of existing literature comparing non-Q-wave infarction and reperfused AMI.
- Analysis of data from the Diltiazem Reinfarction Study and the Multicenter Diltiazem Post-Infarction Trial (non-Q-wave subset).
Main Results:
- Successfully reperfused AMI shares characteristics with non-Q-wave infarction.
- Calcium-channel blocker therapy, exemplified by diltiazem studies, is considered appropriate adjunctive therapy for post-thrombolysis patients.
Conclusions:
- Incomplete infarction following thrombolysis shares features with non-Q-wave infarction.
- Calcium-channel blockers may serve as effective adjunctive pharmacologic therapy in the management of post-thrombolysis myocardial infarction.