[Thrombolysis in acute myocardial infarct. Experience at Santa Maria's Hospital].
OBJECTIVE
To evaluate the experience with i.v. streptokinase (SK) in the treatment of acute myocardial infarction (AMI) in two cardiac care units. Conception: Retrospective analysis of patients (pts) admitted either to UCIM or UTIC-AC with the diagnosis of AMI receiving SK.


METHODS
77 pts were treated, although one of them was later proved to be a false positive diagnosis of AMI. Of the other 76, there were 63 men and 13 women with age 55 +/- 12 (mean age +/- SD) years (limits of 20 and 82 years). AMIs were anterior in 42% of the pts, inferior in 51%, anterior and inferior in 4% and non Q wave in 1%; Killip classes (cl) were: cl I in 64%, cl II in 26%, cl III in 5% an cl IV in 5%. The time interval from the beginning of acute symptoms to the arrival at the hospital was 2.8 +/- 1.2 hours (1 to 15) and from that moment to administration of SK was 1.6 +/- 1.4 h. The whole interval to the administration of SK was 4.4 +/- 2.5 h.


RESULTS
The 3 criteria of reperfusion (pain relief, ST changes resolution and less than 18 h maximum CK rise) were present in 36% of the pts, 2 of the criteria in 21%, and 41% of the pts had only one or no criteria. The time interval to the administration of SK in these 3 groups was 3.3 +/- 1.3 h, 4.8 +/- 3.1 h and 5.0 +/- 2.5 h respectively. Non fatal complications occurred in 16% of the pts (major bleeding in 2.6%, minor bleeding in 99% and minor anafilaxy in 4%. Mortality was 11.8% (9 pts). Two thirds of the deaths were due to cardiac rupture. In hospital residual ischemia was present in 9% (7 pts).


CONCLUSIONS
Treatment of AMI with i.v. SK proved to be a safe and easy to apply therapeutic option, carrying a low morbidity and mortality, lower than that normally observed in our hospital with the conventional approach of AMI before the era of thrombolysis.
Pedro
P G
PG
Diogo
A N
AN
Correia
L C
LC
Costa
J T
JT
Pereirinha
A
A
Araújo
A
A
Ferreira
R
R
Amador
M G
MG
Ribeiro
C
C
de Pádua
F
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D011174:Portugal; D013300:Streptokinase / Q000009:adverse effects / Q000627:therapeutic use*; D015912:Thrombolytic Therapy; D013997:Time Factors
D013300:Streptokinase
Trombólise no enfarte agudo do miocárdio Experiência no Hospital de Santa Maria.