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Improved left ventricular function in myocardial infarction following intravenous thrombolytic therapy with acylated
I Ovsyshcher1, H Silber, M I Hausman
1Department of Cardiology, Soroka Medical Center, Beer-Sheva, Israel.
Insights
Early administration of anisoylated plasminogen streptokinase complex (APSAC) effectively restored blood flow in acute myocardial infarction patients. This treatment preserved left ventricular function and showed a low one-year mortality rate.
Area of Science:
- Cardiology
- Thrombolytic Therapy
- Myocardial Infarction Research
Background:
- Acute myocardial infarction (MI) is a leading cause of mortality.
- Timely reperfusion therapy is critical for preserving left ventricular function.
- Intravenous thrombolytic agents are a key treatment modality.
Purpose of the Study:
- To evaluate the safety and efficacy of anisoylated plasminogen streptokinase complex (APSAC) administered as an intravenous bolus in acute myocardial infarction (MI).
- To assess the impact of early APSAC treatment on reperfusion rates and left ventricular ejection fraction (LVEF).
Main Methods:
- Forty-six patients with acute MI received an intravenous bolus of 30 units of APSAC within three hours of symptom onset.
- Reperfusion was assessed using clinical, electrocardiographic, and enzymatic criteria.
- Left ventricular ejection fraction (LVEF) was measured in patients with successful versus unsuccessful reperfusion.
Main Results:
- Reperfusion was achieved in 67% of patients (31 out of 46).
- Successful reperfusion significantly improved LVEF in both anterior and inferior MI compared to non-reperfusion groups (p < 0.05).
- The one-year mortality rate was 4%, with no serious adverse reactions reported.
Conclusions:
- Bolus intravenous APSAC administration is a safe and effective early treatment for acute myocardial infarction.
- Early reperfusion with APSAC significantly preserves left ventricular function.
- This thrombolytic therapy demonstrates a favorable safety profile and low long-term mortality.
Abstract:
Forty-six patients with acute myocardial infarction (MI) were treated within three hours of the onset of chest pain with an intravenous bolus (IV) of 30 units of anisolated plasminogen activator streptokinase complex (APSAC). Reperfusion was detected in 31 patients (67%) by clinical, electrocardiographic, and enzymatic criteria. The mean time elapsed between the onset of the chest pain to thrombolytic therapy was 114 +/- 53 minutes. Left ventricular ejection fraction (LVEF) was significantly better in patients with anterior and inferior myocardial infarction who had successful reperfusion, as compared with those who did not (48.8 +/- 13.0 vs 35.3 +/- 10.9, p less than 0.05 and 59.7 +/- 12.6 vs 47.9 +/- 15.3, p less than 0.05, respectively). The rate of reocclusion within three weeks was 22%. The overall one-year mortality was 4%. There were no serious adverse reactions following the thrombolytic treatment. Thus bolus IV injection of 30 units of APSAC is both safe and effective in preserving left ventricular function when given early in the course of acute myocardial infarction.