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Thrombolysis in postinfarction angina.

P Ouyang1, E P Shapiro, S O Gottlieb

  • 1Division of Cardiology, Francis Scott Key Medical Center, Baltimore, Maryland 21224.

The American Journal of Cardiology
|September 3, 1991
PubMed
Summary
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Postinfarction angina often leads to recurrent myocardial infarction (MI). This study investigated thrombolytic therapy

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Interventional Cardiology

Background:

  • Postinfarction angina is associated with a high risk of recurrent myocardial infarction (MI) or death within months.
  • Pathophysiological mechanisms include thrombus formation, complex coronary lesions, inadequate collateral circulation, and endothelial dysfunction.
  • While thrombolytic therapy improves outcomes in acute MI, its effect on reducing recurrent ischemia post-MI is unclear.

Purpose of the Study:

  • To evaluate the efficacy of thrombolytic therapy in treating postinfarction angina.
  • To assess the impact of thrombolysis on intracoronary thrombus and silent ischemia in patients with postinfarction angina.

Main Methods:

  • A randomized placebo-controlled trial involving 29 patients with postinfarction angina.

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  • Patients were randomized to receive either thrombolytic therapy (T group, n=12) or placebo (P group, n=17).
  • Coronary angiography was performed post-MI, and Holter monitoring assessed silent ischemia before and after treatment.

    • Main Results:

    • Intracoronary thrombus was present in most patients in both groups before treatment.
    • Thrombolytic therapy resulted in lysis of intracoronary thrombus in a significantly higher proportion of patients in the T group compared to the P group (p < 0.02).
    • Data on silent ischemia changes were collected but not detailed in the truncated abstract.

    Conclusions:

    • Thrombolytic therapy can effectively lyse intracoronary thrombus in patients with postinfarction angina.
    • Further research is needed to determine the clinical impact of thrombolysis on recurrent ischemia and long-term outcomes in this patient population.