Comparison of different pharmacological interventions on enzymatic parameters during acute myocardial infarction.
The concept that acute myocardial infarction is a dynamic event and that different interventions can modify the extent of the necrosis, has led to renewed interest in early pharmacological and surgical treatments designed to reduce the ischemic injury. To evaluate the effects of different pharmacological interventions aimed to reduce the extent of necrosis, we studied 166 patients (138 male and 28 female, mean age of 59.4 +/- 11.3 years) admitted within 6 h after chest pain and treated with a single therapy during the first 72 h. Enzymatic infarct size (IS) was calculated by serial creatine kinase isoenzyme MB determinations using a compartmental model. Six groups of patients were evaluated: 33 patients were treated only with antiplatelet drugs, 38 with anticoagulants, 34 with intravenous thrombolytic therapy, 20 with calcium channel blockers, 25 with nitrates, and 16 with beta-blockers. Estimated IS (gEq/m2) and elimination constant (Kd, U/L/h) did not differ in the six groups, but patients treated with streptokinase had higher release constant (Ka, U/L/h) and shorter time to peak CK-MB value. Early treatment (less than or equal to 2 h after chest pain) had a favourable effect on the enzymatic IS only in patients treated with calcium channel blockers (p less than 0.005).
D000328:Adult; D000368:Aged; D004796:Clinical Enzyme Tests; D003402:Creatine Kinase / Q000097:blood*; D004176:Dipyridamole / Q000627:therapeutic use; D005260:Female; D006321:Heart / Q000187:drug effects; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007527:Isoenzymes; D007548:Isosorbide Dinitrate / Q000627:therapeutic use; D008297:Male; D008790:Metoprolol / Q000627:therapeutic use; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000201:enzymology / Q000473:pathology; D009206:Myocardium / Q000473:pathology*; D009336:Necrosis; D009543:Nifedipine / Q000627:therapeutic use; D005996:Nitroglycerin / Q000627:therapeutic use; D013300:Streptokinase / Q000627:therapeutic use; D014700:Verapamil / Q000627:therapeutic use
D007527:Isoenzymes; D004176:Dipyridamole; D006493:Heparin; D014700:Verapamil; D003402:Creatine Kinase; D013300:Streptokinase; D005996:Nitroglycerin; D008790:Metoprolol; D009543:Nifedipine; D007548:Isosorbide Dinitrate