Recanalization characteristics of intracoronary streptokinase compared to intravenous tissue plasminogen activator following acute myocardial infarction: a community hospital experience.
This study compares the recanalization characteristics of intracoronary streptokinase (IC-SK) with those of intravenous tissue plasminogen activator (t-PA) in patients with acute myocardial infarction (AMI) treated in the first 6 hours after onset of symptoms. We studied 263 patients with AMI. Among these, 160 were treated with IC-SK; in 59 the drug was given within the first 3 hours and in 101 from 3 to 6 hours. Another 103 patients were treated with IV t-PA; in 64 the drug was given in the first 3 hours and in 39 within 3 to 6 hours. The recanalization rate in the IC-SK group at 0 to 3 hours was 73% and at 3 to 6 hours was 71%, with an overall recanalization rate of 72% from 0 to 6 hours. In the t-PA group, the recanalization rate at 0 to 3 hours was 72% and at 3 to 6 hours was 46%, with an overall recanalization rate of 62%. We conclude that during the first 6 hours of AMI, IC-SK treatment resulted in a rather steady thrombolysis rate, while t-PA treatment with the standard regimen produced a significant decline in recanalization when administered after 3 hours from the onset of AMI symptoms.
Ramos
R S
RS
Division of Cardiology, St. Luke's Hospital, St. Louis, Mo, USA.
Salem
B I
BI
Gowda
S
S
Haikal
M
M
Coordes
C
C
Leidenfrost
R
R
D017023:Coronary Angiography; D003331:Coronary Vessels; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000188:drug therapy*; D015425:Myocardial Reperfusion; D012189:Retrospective Studies; D013300:Streptokinase / Q000008:administration & dosage*; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*
D013300:Streptokinase; D010959:Tissue Plasminogen Activator