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[Reperfusion syndrome during thrombolytic therapy of myocardial infarct]
Insights
This study on myocardial infarction found that reperfusion syndrome arrhythmias are life-threatening. Preventive administration of mexitil effectively abolished these arrhythmias, showing good tolerance.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Myocardial infarction frequently involves coronary artery occlusion.
- Intracoronary thrombolytic therapy with streptokinase is a common treatment.
- Reperfusion syndrome can manifest with significant clinical and hemodynamic changes.
Purpose of the Study:
- To assess the manifestations of reperfusion syndrome following streptokinase therapy.
- To identify the most life-threatening complications of reperfusion syndrome.
- To evaluate the efficacy of mexitil and isoptin in preventing adverse reperfusion-induced arrhythmias.
Main Methods:
- Studied 97 patients with myocardial infarction undergoing intracoronary streptokinase therapy.
- Monitored electrocardiographic, clinical, and hemodynamic parameters during reperfusion.
- Assessed the impact of preventive mexitil and isoptin administration on arrhythmias.
Main Results:
- Infarct-related coronary artery occlusion was present in 90% of patients.
- Arrhythmic manifestations were identified as the most dangerous aspect of reperfusion syndrome.
- Preventive mexitil administration significantly abolished prognostically unfavorable arrhythmias.
- Isoptin showed a lesser degree of efficacy in preventing these arrhythmias.
- Mexitil demonstrated good patient tolerance, while isoptin had certain limitations.
Conclusions:
- Arrhythmic complications of reperfusion syndrome pose a significant life-threatening risk in myocardial infarction patients.
- Mexitil is a promising therapeutic agent for preventing severe reperfusion-induced arrhythmias.
- Isoptin may offer some benefit but with limitations compared to mexitil.
Abstract:
Infarct-related coronary artery occlusion was found in 90 out of 97 patients with myocardial infarction and intracoronary thrombolytic therapy was performed by using streptokinase. Electrocardiographic, clinical, and hemodynamic manifestations of the reperfusion syndrome were assessed when the coronary artery became patent. It was concluded that arrhythmic manifestations of the syndrome were the most life-threatening as they might lead to fatal arrhythmias. It was demonstrated that prognostically unfavorable reperfusion-induced arrhythmias might be abolished by a preventive administration of mexitil and, to a lesser degree, isoptin. Good mexitil tolerance and certain limitations of isoptin therapy were also underlined.