title: Effects of early high-dose streptokinase intravenously on left ventricular function in acute myocardial infarction.
abstract: One hundred seven patients who recently had acute myocardial infarction were randomly assigned either to standard heparin therapy or to intravenous streptokinase within 5 hours after the onset of symptoms in 7 hospitals without catheterization facilities. In the third week, the patients were referred to a university hospital, where the patency rate of the infarct-related artery was studied by selective coronary arteriography and left ventricular function by radionuclide angiography. Fifty-five patients received heparin and 52 streptokinase within a mean period of 190 minutes after the onset of symptoms. Seven patients in the heparin group and 4 in the streptokinase group died in hospital. The patency rate of the infarct-related artery was identical in both groups (69% in the heparin group vs 68% in the streptokinase group). Left ventricular ejection fraction was not statistically different (0.44 +/- 0.13 in the heparin group vs 0.45 +/- 0.12 in the streptokinase group). Left ventricular ejection fraction was significantly higher in patients with a patent infarct-related artery than in patients with an obstructed infarct-related artery (0.49 +/- 0.12 vs 0.41 +/- 0.15, p less than 0.01). In patients with inferior wall infarction, left ventricular ejection fraction was identical (0.50 +/- 0.10 in the heparin group vs 0.52 +/- 0.09, in the streptokinase group). In patients with anterior wall infarction, left ventricular ejection fraction was significantly higher in the streptokinase group than in heparin group (0.40 +/- 0.10 vs 0.33 +/- 0.09, p less than 0.05). Analysis of regional wall motion revealed that improvement occurred in the lateral wall of the left ventricle.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.forename: J P
authors.initials: JP
authors.lastname: Bassand
authors.forename: R
authors.initials: R
authors.lastname: Faivre
authors.forename: O
authors.initials: O
authors.lastname: Becque
authors.forename: C
authors.initials: C
authors.lastname: Habert
authors.forename: M
authors.initials: M
authors.lastname: Schuffenecker
authors.forename: P Y
authors.initials: PY
authors.lastname: Petiteau
authors.forename: J C
authors.initials: JC
authors.lastname: Cardot
authors.forename: J
authors.initials: J
authors.lastname: Verdenet
authors.forename: M
authors.initials: M
authors.lastname: LaRoze
authors.forename: J P
authors.initials: JP
authors.lastname: Maurat
mesh_terms: D002986:Clinical Trials as Topic; D017023:Coronary Angiography; D005500:Follow-Up Studies; D006321:Heart / Q000000981:diagnostic imaging; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007262:Infusions, Intravenous; D008875:Middle Aged; D009200:Myocardial Contraction / Q000187:drug effects*; D009203:Myocardial Infarction / Q000188:drug therapy*; D011877:Radionuclide Imaging; D011897:Random Allocation; D013300:Streptokinase / Q000008:administration & dosage / Q000627:therapeutic use*; D013318:Stroke Volume; D013997:Time Factors; D014654:Vascular Patency
chemical_list: D006493:Heparin; D013300:Streptokinase