[The thrombolysis treatment of acute myocardial infarct at the site of the emergency. A randomized double-blind study].
Two million units of urokinase were administered intravenously as a bolus, either before (group I, n = 40) or after hospital admission (group II, n = 38), to 66 men and 12 women (mean age 55 +/- 8 years) with typical symptoms of acute myocardial infarction of less than 4 hours' duration. Time elapsed between onset of symptoms and urokinase administration averaged 85 +/- 51 min for group I and 137 +/- 50 min for group II (P less than 0.005). The complication rate was low, both during the pre-hospital and the hospital phases, without any significant differences between the two groups. The rate of open infarct vessels (by angiography before discharge from hospital) was 61% for group I and 67% for group II (no significant difference). Global left ventricular function, regional wall motion in the infarct area and maximal creatinekinase values did not significantly differ between the two groups (ejection fraction 51 +/- 10% and 53 +/- 14%, respectively; creatinekinase 838 +/- 634 U/l and 924 +/- 595 U/l, respectively). The data indicate that thrombolytic pre-hospital treatment carried a low risk. The gain of 45 min, however, seems to be of secondary importance in any significant diminution of the acute infarction size.
Mathey
D G
DG
Universitäts-Krankenhaus Eppendorf.
Büttner
J
J
Geng
G
G
Gutschmidt
H J
HJ
Herden
H N
HN
Moecke
H
H
Polster
H
H
Raftopoulo
R
R
Schofer
J
J
Sheehan
F H
FH
D017023:Coronary Angiography; D003402:Creatine Kinase / Q000097:blood; D004311:Double-Blind Method; D004562:Electrocardiography; D004630:Emergencies; D005260:Female; D005392:First Aid; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D013318:Stroke Volume / Q000187:drug effects; D015912:Thrombolytic Therapy; D013997:Time Factors; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage*
D003402:Creatine Kinase; D014568:Urokinase-Type Plasminogen Activator
Thrombolyse-Behandlung des akuten Myokardinfarktes am Notfallort. Eine randomisierte Doppelblindstudie.