title: Intravenous streptokinase in evolving acute myocardial infarction.
abstract: Eighty-one consecutive patients presenting within 3 hours of the onset of acute myocardial infarction (AMI) and without contraindications to thrombolytic or anticoagulant therapy received a 15- to 30-minute intravenous infusion of 750,000 or 1.5 million units of streptokinase (STK) followed by anticoagulation. Treatment was instituted 130 +/- 41 minutes after the onset of symptoms and reperfusion was achieved 36 +/- 26 minutes later. Reperfusion of the "infarct artery" was recognized by indirect clinical criteria in 78 patients (96%). In all 66 patients who underwent coronary angiography 3 to 7 days later, there was complete concordance between indirect and angiographic evidence of reperfusion. In 6 patients there was early reocclusion within 24 hours of treatment; in 4 of these patients, the artery was reopened with an additional dose of STK. Two elderly patients suffered an intracranial hemorrhage and there were 8 other major hemorrhagic complications, of which 7 were related to procedural trauma. Five patients (6.2%) died in the hospital. The results of intravenous STK thrombolytic therapy are compared with those of our previous study using intracoronary STK.
mesh_terms: D000368:Aged; D003251:Constriction, Pathologic; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000187:drug effects; D003327:Coronary Disease / Q000209:etiology; D003331:Coronary Vessels / Q000473:pathology; D003402:Creatine Kinase / Q000097:blood; D004562:Electrocardiography; D006801:Humans; D007263:Infusions, Parenteral; D007527:Isoenzymes; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000201:enzymology; D011379:Prognosis; D013300:Streptokinase / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D007527:Isoenzymes; D003402:Creatine Kinase; D013300:Streptokinase