[Time dependence of myocardial preservation after thrombolysis. Consequences for indication and procedure].
To examine whether the limitation in infarct size after effective thrombolytic therapy is time-dependent the relationship between left ventricular wall motion in the infarct region and the time interval between onset of symptoms and intracoronary streptokinase infusion was investigated. The relationship was significant: When intracoronary thrombolytic therapy was begun within 2 hours, wall motion was almost always within normal limits, whereas the probability of wall motion improvement fell to less than 50%, when treatment was begun later. As a further step a lysis procedure was examined which took account of these findings: the intravenous bolus injection of urokinase. Approximately one hour after bolus injection coronary patency could be demonstrated angiographically in 60% of the infarct patients. A clinically relevant limitation of the infarct size was found in those patients in whom lysis therapy could be begun within 2 hours. On the basis of these findings, a thrombolytic therapy seems to be indicated in all patients with acute myocardial infarction when lysis treatment can be begun within 2 hours. The intravenous urokinase therapy, by virtue of its simplicity, is an alternative to intravenous streptokinase therapy.
D000792:Angiography / Q000379:methods; D005342:Fibrinolysis / Q000187:drug effects*; D006321:Heart / Q000187:drug effects*; D006801:Humans; D009203:Myocardial Infarction / Q000188:drug therapy; D013300:Streptokinase / Q000627:therapeutic use*; D013997:Time Factors; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use*
D013300:Streptokinase; D014568:Urokinase-Type Plasminogen Activator
Zeitabhängigkeit der Myokarderhaltung nach Thrombolyse. Konsequenzen für Indikation und Vorgehen.