Related Experiment Video
Updated: Aug 14, 2026
Prehospital Thrombolysis: A Manual from Berlin
Published on: November 26, 2013
Coronary thrombolysis with intravenous urokinase in patients with acute myocardial infarction
Insights
Timely thrombolytic therapy after acute myocardial infarction (MI) significantly improves myocardial salvage. Prompt treatment limits infarct size, preserving heart function and indicating successful reperfusion in patients with coronary artery disease.
Area of Science:
- Cardiology
- Cardiovascular Medicine
- Interventional Cardiology
Background:
- Regional left ventricular wall motion post-myocardial infarction (MI) assesses myocardial salvage and infarct size limitation by thrombolytic therapy.
- Early studies showed limited regional wall motion improvement (40%) after successful intracoronary thrombolytic therapy, leaving the reasons for incomplete salvage unclear.
Purpose of the Study:
- To investigate the time dependency of coronary occlusion on myocardial salvage in clinical settings.
- To examine the relationship between regional wall motion and time to thrombolytic therapy in acute MI patients.
Main Methods:
- Assessed regional left ventricular wall motion as an index of infarct size.
- Correlated wall motion with the time from symptom onset to thrombolytic therapy as an index of coronary occlusion duration.
- Evaluated the efficacy and safety of intravenous urokinase bolus injections.
Main Results:
- Demonstrated a time dependency between duration of coronary occlusion and myocardial salvage in patients with acute MI.
- Established that earlier thrombolytic therapy leads to better regional wall motion and preserved myocardial function.
- Confirmed the efficacy and safety of intravenous urokinase for acute MI treatment.
Conclusions:
- The duration of coronary occlusion is a critical factor influencing myocardial salvage after acute MI.
- Prompt initiation of thrombolytic therapy is essential for limiting infarct size and improving clinical outcomes.
- Intravenous urokinase is an effective and safe treatment option for acute myocardial infarction.
Abstract:
Regional left ventricular wall motion, about two to three weeks after acute myocardial infarction (MI), is perhaps the best clinical measure of myocardial salvage and limitation of infarct size by thrombolytic therapy. Normal or only slightly depressed wall motion at the site of infarction indicates significant limitation of infarct size, whereas markedly abnormal wall motion indicates irreversible myocardial damage. Early studies found significant improvement in regional wall motion in only 40 percent of patients undergoing successful intracoronary thrombolytic therapy after the onset of symptoms of acute MI. Why only 40 percent of these reperfused patients demonstrated salvage of ischemic myocardium could not be answered at that time. Animal experiments show that the duration of coronary occlusion is an important factor in determining myocardial salvage after reperfusion. To study whether this time dependency also exists under clinical circumstances in patients with coronary artery disease, the relationship between regional wall motion (as an index of infarct size) and the time to thrombolytic therapy after the onset of symptoms (as an index of duration of coronary occlusion) was examined. After showing that such time dependency does indeed exist in patients with acute MI, the efficacy and safety of intravenous bolus injections of urokinase were then demonstrated.
Related Concept Videos
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
01:28Cardiac Catheterization I: Pre-Procedure Overview
01:30Acute Coronary Syndrome I: Introduction
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:29Venous Thrombosis III: Interprofessional Care
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care