[Immediate and long-term results of thrombolytic therapy in patients with myocardial infarct: the necessity of differential treatment].
Systemic thrombolytic therapy was performed in 273 patients with large myocardial infarction: 82 on streptokinase, 25 on tissue plasminogen activator, and 166 on streptodecase. The signs of recovered coronary blood flow were observed in 68, 84, and 33% of the patients, respectively. The application of tissue plasminogen activator resulted in the maximum reperfusion. The success of thrombolytic therapy was related to the fibrinolytic system of a patient: reperfusion was achieved in 96% of patients having a high blood fibrinolytic activity and only in 31% with a low one. The clinical effect of reperfusion was most profound in patients with Killip's Class III heart failure. The patients with early recovery of coronary blood flow developed twice more frequently, which was evidenced by a 12-month follow-up. Fifty percent of patients with an ejection fraction of below 40% died within the first year of the follow-up. The authors discuss whether one can use a differential therapy, including surgical tools for myocardial revascularization.
Polikov
A P
AP
Zvereva
T V
TV
D003326:Coronary Circulation; D005069:Evaluation Studies as Topic; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy*; D013300:Streptokinase / Q000008:administration & dosage; D015912:Thrombolytic Therapy; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage
D013300:Streptokinase; D010959:Tissue Plasminogen Activator
Blizhaĭshie i otdalennye rezul'taty tromboliticheckoĭ terapii u bol'nykh infarktom miokarda: neobkhodimost' differentsirovannogo lecheniia.