Coronary perfusion during acute myocardial infarction with a combined therapy of coronary angioplasty and high-dose intravenous streptokinase.
Why the study?
Does immediate high-dose intravenous streptokinase followed by emergency coronary angioplasty improve coronary perfusion in patients with acute myocardial infarction?
Population
216 patients with acute myocardial infarction
Design
Cohort
Follow-up
in-hospital
Authors
Discussion
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Member takes
Implication
Should not yet change AMI reperfusion practice; leaves open whether combined streptokinase-angioplasty improves outcomes versus contemporary care.
Key Points
- The aim is to evaluate the efficacy of high-dose intravenous streptokinase followed by angioplasty in acute myocardial infarction patients.
- Two hundred and sixteen patients treated with high-dose streptokinase infusion and emergency angioplasty.
- In-hospital follow-up included cardiac catheterization to assess vessel patency and outcomes.
- Multivariable analysis indicated factors affecting mortality rates among patients.
- Persistent coronary perfusion achieved in 90% of cases, with significant residual stenosis in 3%.
- In-hospital mortality rate was 12%, with higher rates observed in those with cardiogenic shock (41%).
- Ejection fraction improved significantly from 44% to 49% (p<0.0001) among patients with successful perfusion.
Structured PICO
Does immediate high-dose intravenous streptokinase followed by emergency coronary angioplasty improve coronary perfusion in patients with acute myocardial infarction?
P
Population
216 patients with acute myocardial infarction
I
Intervention
Immediate infusion of high-dose (1.5 million units) intravenous streptokinase followed by emergency coronary angioplasty
O
Outcome
Persistent coronary perfusion after the proceduresurrogate
A combined strategy of high-dose intravenous streptokinase and emergency coronary angioplasty for acute myocardial infarction yields high rates of early and sustained infarct-related vessel patency.
Cite This Study
Stack et al. (1988) studied this question.