[Intravenous thrombolysis in acute myocardial infarct. Clinical and angiography results in 124 patients and the significance of early revascularization].
124 patients with evolving acute myocardial infarction received high-dose intravenous streptokinase (1.5 Mio U within 60 min i.v.). Hospital mortality was 4% and 11% of the patients suffered from a streptokinase-related complication (most frequent bleeding problems). All complications could be treated medically. The angiographic control in 111 patients (90%) after a mean of 11 +/- 8 days after thrombolysis demonstrated a patent antegrade perfused infarct-artery in 85 patients (77%). From the first 55 patients only 16% had a revascularization procedure. An early revascularization in 39 patients (57%) of the last 69 patients reduced the reinfarction rate from 15 to 7%. The hospital mortality was not influenced (3.6 vs 4.3%). High-dose i.v. streptokinase-application is associated with low treatable complication rates and clinically relevant reperfusion rates. An early revascularization (coronary angioplasty, bypass-surgery) reduces the reinfarction rate to about 50% and improves left ventricular function.
D000368:Aged; D000800:Angioplasty, Balloon; D003131:Combined Modality Therapy; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000188:drug therapy*; D003328:Coronary Thrombosis / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D013300:Streptokinase / Q000009:adverse effects / Q000627:therapeutic use*
D013300:Streptokinase
Intravenöse Thrombolyse beim akuten Myokardinfarkt. Klinische und angiographische Ergebnisse bei 124 Patienten und die Bedeutung einer frühzeitigen Revaskularisation.