[Streptokinase treatment in acute myocardial infarction].
Myocardial necrosis develops gradually after coronary artery occlusion, and in man is completed after several hours. Most infarctions are precipitated by thrombi, and early fibrinolytic treatment should therefore be the rational therapy. Recanalization is achieved in three of four patients whether streptokinase is applied intracoronary or intravenously. Early treatment limits the size of the infarct, and he myocardial function is preserved better in patients treated with streptokinase than in others. Very early treatment, started within one hour from the onset of nitroglycerin-resistant chest pain, may prevent infarction in some patients. Streptokinase reduces mortality after infarction, in total by as much as 25 per cent, and even considerably more when infusion is started early. There is some risk of bleeding, but serious bleeding episodes are rare. Intracoronary application has no advantages as compared with intravenous infusion. Unless there are strong contra-indications, patients with nitroglycerin-resistant chest pain and abnormal ECG should receive streptokinase intravenously in a dose of 1.5 x 10(6) units. Most patients treated with streptokinase should be given acetylsalicylic acid.
Dale
J
J
Wik
B
B
D006801:Humans; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000473:pathology; D013300:Streptokinase / Q000009:adverse effects / Q000627:therapeutic use*; D013997:Time Factors
D013300:Streptokinase
Streptokinasebehandling ved akutt hjerteinfarkt.