[Treatment of acute myocardial infarct with ST segment elevation with a combination of fibrinolytic therapy and abciximab].
BACKGROUND
According to current knowledge, the best way to treat the acute myocardial infarction with ST elevation is primary transluminal coronary angioplasty, which can be performed only in the best equipped tertiary cardiology centers. As it was known that atherothrombosis wais the essence of the acute coronary syndrome we wanted to examine the efficacy and safety of combined therapy of tissue plasminogen activator and glycoprotein IIbIIIa platelet receptor antagonist abciximab.


METHODS
The case is reported of combined abciximab and accelerate schedule of t-PA reperfusion therapy in a young patient with the extensive anterior acute myocardial infarction. Activated partial thromboplastin time and platelet count were regularly measured during therapy.


RESULTS
The combination of these two drugs did not cause any complication in our patient. According to early noninvasive parameters, successful reperfusion was achieved. Postinfarction period was without complications. Coronary angiography was performed 15 days after and was without pathological findings. Eighteen months later the event patient had neither chest pain, nor other complaints with slightly reduced R waves in middle precordial leads and hypokinesis of anterior apical segment of the left ventricle showing the signs of important systolic function impairment.


CONCLUSIONS
Controlled studies are needed to prove the safety and the benefit of such combined reperfusion therapy and to show which kind of treatment is appropriate in every case considering the patient conditions and the facilities of coronary care unit.
Gligić
Branko
B
Vojnomedicinska akademija, Klinika za urgentnu internu medicinu, Beograd.
Dincić
Dragan
D
Obradović
Slobodan
S
Marković
Milić
M
Orozović
Vjekoslav
V
D000077284:Abciximab; D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D004562:Electrocardiography; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use*; D008297:Male; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000503:physiopathology; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors*; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use
D000911:Antibodies, Monoclonal; D005343:Fibrinolytic Agents; D007140:Immunoglobulin Fab Fragments; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D010959:Tissue Plasminogen Activator; D000077284:Abciximab