Effect of continued rt-PA administration on the residual stenosis after initially successful recanalization in acute myocardial infarction--a quantitative coronary angiography study of a randomized trial.
Quantitative angiography was performed in 68 out of 123 patients treated with intravenous rt-PA for acute myocardial infarction. At 90 min angiography, the median minimal cross-sectional area was 1.11 mm2 and the median percentage area stenosis was 80%. A percentage area stenosis greater than 70% was seen in 78% of the patients. Patients with a patient infarct related artery at the first angiogram were randomized to receive subsequent infusions either of rt-PA + heparin or placebo + heparin. There was a persistent trend of improvement in minimal lumen diameter and percentage diameter stenosis of the residual stenosis in the infarct related artery in both treatment groups when re-examined 6-24 hours later and at the time of hospital discharge. A reduction in 'plaque area', the area between the detected and the reference contours of the infarct related segment, was more frequently seen in patients receiving a second infusion of rt-PA than in patients with no prolonged thrombolytic therapy (83% versus 57%, P less than 0.025, chi square).
D002932:Cineangiography; D002986:Clinical Trials as Topic; D017023:Coronary Angiography; D005500:Follow-Up Studies; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D009203:Myocardial Infarction / Q000188:drug therapy*; D011857:Radiographic Image Interpretation, Computer-Assisted; D011897:Random Allocation; D011994:Recombinant Proteins / Q000627:therapeutic use; D012008:Recurrence; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D014654:Vascular Patency / Q000187:drug effects
D011994:Recombinant Proteins; D006493:Heparin; D010959:Tissue Plasminogen Activator