title: [Effectiveness of pre-hospital thrombolytic therapy in acute myocardial infarction].
abstract: The efficacy and risk of prehospital thrombolysis for acute myocardial infarction (MI) were evaluated in a randomized trial. Patients received streptokinase, 500,000 U, and heparin, 10,000 U, intravenously within 5-10 minutes before (Group 1, n = 50) or after (Group 2, n = 50) hospital admission. One hundred patients took conventional therapy (Group 3). The mean time interval between the onset of symptoms and thrombolytic therapy was 2.2, 4.5, and 3.8 hours in Groups 1, 2, and 3, respectively (p < 0.001). Severe hemorrhages were absent. The rate of ventricular fibrillation was the same in Groups 1 and 3 prior to hospitalization. Left ventricular contractility was identical in Groups 1 and 2. By the end of the fourth week, Group 1 showed a 14% increase in ejection fraction and a 14.5% decrease in akinetic segment, these parameters substantially unchanged in Group 2. The MI size assessed by ECG and the maximum myoglobin concentrations was significantly less in Group 1 than that in Group 2. The patients from Group 1 had fewer MI complications than those from Groups 2 and 3. Three patients died in Group 1, 6 in Group 2, and 16 in Group 3. (p < 0.05).
authors.forename: R S
authors.initials: RS
authors.lastname: Karpov
authors.forename: V A
authors.initials: VA
authors.lastname: Markov
authors.forename: A M
authors.initials: AM
authors.lastname: Danilenko
authors.forename: V I
authors.initials: VI
authors.lastname: Varvarenko
authors.forename: R M
authors.initials: RM
authors.lastname: Zakharova
authors.forename: K Iu
authors.initials: KIu
authors.lastname: Dzhavadov
authors.forename: V M
authors.initials: VM
authors.lastname: Radionov
authors.forename: A Iu
authors.initials: AIu
authors.lastname: Fedorov
authors.forename: I V
authors.initials: IV
authors.lastname: Maksimov
mesh_terms: D000328:Adult; D000368:Aged; D004632:Emergency Medical Services; D005260:Female; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy*; D013300:Streptokinase / Q000627:therapeutic use*; D015912:Thrombolytic Therapy
chemical_list: D006493:Heparin; D013300:Streptokinase
vernacular_title: Effektivnost' tromboliticheskoĭ terapii ostrogo infarkta miokarda na dogospital'nom étape.