当前位置： SCI文献检索 > JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY期刊下所有文献 > Optimal utilization of thrombolytic therapy for acute myocardial infarction: concepts and controversies.

Optimal utilization of thrombolytic therapy for acute myocardial infarction: concepts and controversies.

Abstract：

:Timely administration of thrombolytic therapy decreases myocardial infarct size, lessens the incidence of congestive heart failure and improves survival. However, available data suggest that only 10% of patients with acute infarction in the United States receive thrombolytic drugs. Given the benefits of thrombolytic therapy, all patients with myocardial infarction would likely be treated were it not for associated risks. Several groups exist in which the risk/benefit ratio of thrombolytic therapy continues to be controversial, including those with inferior infarction, absence of ST segment elevation or presentation greater than 6 h from symptom onset, elderly patients and those with hypertension. Three recent thrombolytic trials reported a reduction in mortality that was entirely independent of infarct location. Pooled data from trials involving 12,000 patients with inferior infarction have demonstrated a reduction in mortality rate (6.8% versus 8.7%, p less than 0.0001). Furthermore, improvement in regional and global left ventricular function occurred after reperfusion therapy of inferior infarction. Pooled data indicate that patients treated between 6 and 24 h after symptom onset have a lower mortality rate than do those who receive placebo (11.1% versus 13.1%, p less than 0.001). Improved survival occurs after thrombolytic therapy in patients with ST segment elevation or left bundle branch block, but not in those with isolated ST depression or a normal electrocardiogram. Age should not be considered an absolute contraindication because the lifesaving potential of thrombolytic therapy in the elderly may be two to three times that of the overall group of patients with myocardial infarction. Finally, recent studies demonstrated that patients who present with hypotension or hypertension or who have undergone cardiopulmonary resuscitation may also benefit.(ABSTRACT TRUNCATED AT 250 WORDS)

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Grines CL,DeMaria AN

doi

10.1016/0735-1097(90)90482-5

subject

Has Abstract

pub_date

1990-07-01 00:00:00

pages

223-31

issue

eissn

0735-1097

issn

1558-3597

pii

0735-1097(90)90482-5

journal_volume

pub_type

杂志文章,评审

在线工具

Optimal utilization of thrombolytic therapy for acute myocardial infarction: concepts and controversies.