Intravenous versus intracoronary streptokinase therapy for acute myocardial infarction in community hospitals.
A consecutive series of 184 patients with acute myocardial infarction (AMI) received thrombolytic therapy. The first 63 were treated in the catheterization laboratory with intracoronary streptokinase (IC-STK), and 44 (70%) had successful thrombolysis. One hundred twenty-one patients received intravenous (IV) STK immediately after diagnosis of AMI, and 99 (82%) were found to have an open infarct artery. Only 58% of patients (14 of 24) who required transfer from out-of-town hospitals for IC-STK treatment had successful thrombolysis; in contrast, IV-STK given in the local hospital resulted in an 85% (72 of 85) rate of thrombolysis (p = 0.005). IV-STK thus appears at least as effective as IC-STK for AMI and is more effective for patients treated in hospitals without catheterization facilities.
D000368:Aged; D006328:Cardiac Catheterization; D003331:Coronary Vessels; D005260:Female; D006764:Hospitals, Community; D006801:Humans; D007263:Infusions, Parenteral; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000503:physiopathology; D013300:Streptokinase / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D013318:Stroke Volume / Q000187:drug effects; D013997:Time Factors
D013300:Streptokinase