Sustained improvement in left ventricular function and mortality by intracoronary streptokinase administration during evolving myocardial infarction.

Abstract:

:One hundred eighty-eight patients with acute myocardial infarction were studied prospectively from August 1980 to September 1982. One hundred thirty-six of these patients were entered into a intracoronary streptokinase study after informed consent was obtained. The remaining 52 patients, who either met exclusion criteria for the study or refused to participate, served as a control group and were treated as those in the study group except that they did not undergo emergency cardiac catheterization. Left ventricular function was determined in both groups by gated radionuclide ejection fraction (EF) on admission to the hospital, at discharge, and 6 months after discharge. With successful reperfusion up to 18 hr after onset of chest pain, mean left ventricular function in the study group improved (EF 39 +/- 13% on admission and 46 +/- 12% at discharge; p less than .001). Mean EF in control patients and those not achieving reperfusion did not change from admission to discharge. Mean EF at 6 month follow-up was not significantly different than at discharge in the study group or the control group. Total cardiac mortality in the control group was 19% compared with 10% in the study group (p = .06, NS). When patients admitted in pulmonary edema or shock (Killip class III or IV) were excluded from both groups, total cardiac mortality in the study group was significantly lower (4%) compared with in the control group (12.5%, p less than .05. The administration of intracoronary streptokinase during evolving myocardial infarction up to 18 hr after onset of chest pain may result in decreased mortality and sustained improvement in left ventricular function.

journal_name

Circulation

journal_title

Circulation

authors

Smalling RW,Fuentes F,Matthews MW,Freund GC,Hicks CH,Reduto LA,Walker WE,Sterling RP,Gould KL

doi

10.1161/01.cir.68.1.131

subject

Has Abstract

pub_date

1983-07-01 00:00:00

pages

131-8

issue

1

eissn

0009-7322

issn

1524-4539

journal_volume

68

pub_type

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