Improvement of regional myocardial metabolism after coronary thrombolysis induced with tissue-type plasminogen activator or streptokinase.

Abstract:

:To assess the effects on the heart itself of coronary thrombolysis induced with either tissue-type plasminogen activator (t-PA) or streptokinase (SK), we performed positron emission tomography with 11C-palmitate in 19 patients with initial transmural myocardial infarction immediately after admission and again within 48 to 72 hr after intracoronary administration of t-PA (n = 2) or SK (n = 17). Clots were persistent in eight patients treated with SK despite an average dose of 336,000 IU, sufficient to markedly deplete fibrinogen. In the absence of lysis, favorable tomographic changes did not occur. In contrast, in each of the 11 patients in whom lysis was induced (two with t-PA and nine with SK) myocardial accumulation of 11C-palmitate improved by an average of 29% in late compared with early studies (p less than .001). Results were comparable in patients with anterior and those with inferior infarction. Thus clot lysis induced with either t-PA or SK led to improved regional myocardial metabolism.

journal_name

Circulation

journal_title

Circulation

authors

Sobel BE,Geltman EM,Tiefenbrunn AJ,Jaffe AS,Spadaro JJ Jr,Ter-Pogossian MM,Collen D,Ludbrook PA

doi

10.1161/01.cir.69.5.983

subject

Has Abstract

pub_date

1984-05-01 00:00:00

pages

983-90

issue

5

eissn

0009-7322

issn

1524-4539

journal_volume

69

pub_type

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