Thrombolytic therapy in acute coronary thrombosis.
Thrombolytic agents administered intravenously have been shown to have a salutary effect in the early management of acute myocardial infarction. However, a debate still is pending over the definite choice of an ideal thrombolytic agent. In our 83-bed community hospital, from January 1986 to September 1988, we treated 19 patients (n = 19) with acute myocardial infarction (average one patient every six weeks) with either intravenous streptokinase (IV STK) or intravenous tissue plasminogen (IV TPA) with a mean follow-up of 20.2 months. We compared both groups in terms of clinical reperfusion, morbidity and mortality, cost-effectiveness and long-term functional disability. Our results showed that most patients received their respective agents within four hours of the onset of chest pain (81% in the STK group, n = 11, versus 75% of the tPA group, n = 8). In the STK group, 90.9% showed clinical evidence of reperfusion compared to 87.5% in the TPA one, the difference not being statistically significant. Two patients in the STK group developed a treatable bradycardia, and one showed a junctional rhythm that was corrected. One patient in the TPA subset encountered a reversible ventricular tachycardia. However, we didn't note any bleeding complication in either group.
Ramalanjaona
G R
GR
Huntington Memorial Hospital, IN 46750.
Mathew
J C
JC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002986:Clinical Trials as Topic; D003362:Cost-Benefit Analysis; D004341:Drug Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy*; D012189:Retrospective Studies; D013300:Streptokinase / Q000008:administration & dosage / Q000627:therapeutic use*; D015912:Thrombolytic Therapy / Q000009:adverse effects / Q000191:economics; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
D013300:Streptokinase; D010959:Tissue Plasminogen Activator