Related Experiment Videos
[Early systemic thrombolysis in acute myocardial infarction: clinical and angiographic results]
J A Rodríguez1, R Corbalán, S Kunstmann
1Departamento de Enfermedades Cardiovasculares, Hospital Clínico Pontificia, Universidad Católica de Chile, Santiago.
Insights
Systemic thrombolysis effectively treats acute myocardial infarction by restoring coronary flow. This study confirms its safety and efficacy, achieving high rates of clinical and angiographic reperfusion in patients treated early.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Systemic thrombolysis is a crucial intervention for acute myocardial infarction (AMI).
- It aims to restore coronary blood flow and preserve left ventricular function.
- Early treatment is vital for improved patient outcomes.
Purpose of the Study:
- To evaluate the safety and efficacy of intravenous thrombolytic therapy in patients with AMI.
- To assess reperfusion rates based on clinical and biochemical markers.
- To analyze angiographic findings post-thrombolysis.
Main Methods:
- Retrospective analysis of 45 AMI patients treated within 6 hours of symptom onset.
- Administration of streptokinase (38 patients) or tissue plasminogen activator (7 patients).
- Reperfusion criteria included symptom resolution, ST-segment normalization, and early creatine phosphokinase (CPK) peak.
Main Results:
- 64% of patients (29/45) met reperfusion criteria.
- Coronary angiography revealed a patent artery in the infarct zone in 74% (28/38) of cases.
- Adverse events included transient hypotension (38%) and bleeding complications (7%).
Conclusions:
- Intravenous thrombolytic therapy is a safe and effective treatment for early acute myocardial infarction.
- The therapy is associated with a high incidence of both clinical and angiographic reperfusion.
- Early intervention with thrombolysis can significantly improve outcomes in AMI patients.
Abstract:
Systemic thrombolysis is an effective therapy for acute myocardial infarction, since it restores coronary flow and contributes to preserve left ventricular function. We analyze our experience with intravenous thrombolytic therapy in 45 cases with acute myocardial infarction treated within 6 hours of onset of symptoms. 28 patients had anterior and 17 inferior myocardial infarction. We treated 38 patients with streptokinase 1 to 1.5 million units infused during a 30 to 60 minute period and 7 patients with tissue plasminogen activator factor, 100 mg infused during 2 hours. Regression of chest pain and ST segment elevation and early CPK peaking (less than 4 hours) were utilized as criteria for reperfusion. Accordingly 29 patients (64%) met these criteria. Coronary angiogram was performed within 7 days in 38 patients. It disclosed a patent coronary artery in the infarcted area in 28 cases (74%). Transient hypotension with thrombolytic therapy was observed in 17 patients (38%) and bleeding complications in 3 cases (7%). Two patients (4%) died early after therapeutic failure. In summary we have confirmed that intravenous thrombolytic therapy is safe and effective in the early period of myocardial infarction and that is associated with a high incidence of clinical and angiographic reperfusion.