[Effect of thrombolytic therapy on parameters of endothelial function in patients with myocardial infarction].
OBJECTIVE
A comparative estimation of influence various thrombolytic preparations(alteplase, Streptokinase) on clinical course and the remote forecast of disease, and also of parameters of a metabolism of nitric oxide of the patient with acute myocardial infarction.


METHODS
In research have included 70 patients with acute myocardial infarction (MI) with rise of segment ST. Patients have been divided into groups depending on a kind of applied thrombolytic agent. Estimated features of clinical current by MI in both groups of patients , year forecast of disease, parameters of a metabolism nitric oxide and oxidative stress and antioxidative defence during the acute period of MI.


RESULTS
Greater efficiency thrombolytic therapies is revealed in group of patients with application of alteplase. The patients in group of alteplase were characterised by more favorable current both acute and remote periods of MI. In these patients more significant activation of parameters of oxidative stress is revealed, than in group of application of streptokinase. This is caused by more effective revascularisation and reperfusion of myocardium. In group of patients treat with the streptokinase decrease in the level of stable metabolites of nitric oxide is more marked, than in group of patients with alteplase. Statistically significant increase of this parameters is revealed in group with endothelial protection by alteplase.


CONCLUSIONS
Advantages of the tissue plasminogen activator alteplase concerning influence on clinical course of the acute period of MI and the remote forecast are shown, that, apparently is connected not only with greater frequency of effective revascularisation of a myocardium, but also with optimization of endothelial functions of patients with MI.
Barbarash
O L
OL
Research Institute for Cardiology of the Research Centre of RAMS Siberian Branch, ul. Kievskaya 111, 634012 Tomsk, Russia.
Kashtalap
V V
VV
Voroncova
N L
NL
Suslova
T E
TE
Karetnikova
V N
VN
Barbarash
L S
LS
D000328:Adult; D000368:Aged; D004730:Endothelium, Vascular / Q000187:drug effects / Q000378:metabolism / Q000503:physiopathology*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D009569:Nitric Oxide / Q000378:metabolism; D013053:Spectrophotometry; D013300:Streptokinase / Q000627:therapeutic use*; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome; D014664:Vasodilation / Q000187:drug effects / Q000502:physiology*
D005343:Fibrinolytic Agents; D009569:Nitric Oxide; D013300:Streptokinase; D010959:Tissue Plasminogen Activator