[Intravenous streptokinase infusions in acute myocardial infarction. Restoring patency of occluded thrombotic coronary vessels (author's transl)].
Intravenous treatment over 30 minutes with 500 000 U streptokinase was given to 21 patients with acute myocardial infarction. Serial measurements of serum CK-MB activity made recanalisation of the infarcted artery likely in 3 patients. Selective coronarography was performed in 18 patients during the acute infarction phase. Angiographic follow-up investigations were done 24 hours and after 3 weeks. In 3 cases only subtotal occlusion of the infarcted coronary artery was seen during the acute phase. A thrombus demonstrated in two patients could be lysed. In 8 out of 15 patients with complete coronary artery occlusion the infarcted vessel was reopened 20-60 minutes after onset of intravenous streptokinase infusion. In a further 4 patients recanalisation was observed 60-140 minutes after passing a guide wire or during an additional intracoronary infusion of streptokinase. The infarcted vessel remained occluded in 3 patients, one of whom died following myocardial rupture. In 12 patients with recanalisation of the infarcted artery during the acute phase a premature maximum of serial CK-MB serum activity was seen after 13.5 +/- 2.9 hours in comparison with 20.9 +/- 5.3 hours in 122 patients treated conventionally. Serial enzyme determinations allow indirect conclusions as to a rapid recanalisation of an infarcted blood vessel.
D000790:Angiocardiography; D017023:Coronary Angiography; D003402:Creatine Kinase / Q000097:blood; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000201:enzymology; D013300:Streptokinase / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use
D005343:Fibrinolytic Agents; D003402:Creatine Kinase; D013300:Streptokinase
Intravenöse Streptokinase-Infusion bei akutem Myokardinfarkt. Wiederöffnung thrombotisch verschlossener Herzkranzgefässe.