Early reperfusion assessment and repeated thrombolysis in acute myocardial infarction estimated by repeated standard electrocardiography. A randomised, double-blind, placebo-controlled pilot study.
Thrombolytic therapy with streptokinase (SK) in acute myocardial infarction (AMI) does not result in early reperfusion in approximately 25% of patients. We hypothesized that early repeated thrombolysis with rt-PA in patients with early failed reperfusion would result in myocardial reperfusion. Fifty-nine AMI patients with a symptom delay of <6 h, treated with SK were included. ECG was taken on admission and after 90 and 180 min. An ST recovery of > or =25% at 90 min was interpreted as successful reperfusion. Sixteen patients had failed reperfusion at 90 min and were randomized to repeated thrombolysis with rt-PA or placebo. At 180 min from SK start, ST recovery was higher in the placebo group than in the rt-PA group (71 vs. 40%, p = 0.05). No serious bleeding complications were observed. Due to the limited sample size it was not possible to draw prominent conclusions.
Gill
S
S
Department of Cardiology, Odense University Hospital, Odense Denmark, Denmark. Sabine.Gill@dadlnet.dk
Haastrup
B
B
Haghfelt
T
T
Dellborg
M
M
Clemmensen
P M
PM
D000328:Adult; D000368:Aged; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000188:drug therapy*; D015425:Myocardial Reperfusion / Q000379:methods; D010865:Pilot Projects; D010960:Plasminogen Activators / Q000008:administration & dosage*; D011336:Probability; D011379:Prognosis; D012016:Reference Values; D018709:Statistics, Nonparametric; D013300:Streptokinase / Q000008:administration & dosage*; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D017211:Treatment Failure; D016896:Treatment Outcome
D013300:Streptokinase; D010960:Plasminogen Activators; D010959:Tissue Plasminogen Activator