What question did this study set out to answer?

To evaluate clinical outcomes and coronary artery patency during a 3-month follow-up in patients receiving early intravenous streptokinase for acute myocardial infarction.

February 1, 1987Archives of Internal Medicine

Early Treatment of Acute Myocardial Infarction With Intravenous Streptokinase

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Population

51 successive patients with acute myocardial infarction

Design

Cohort

Follow-up

3 months posthospital

Authors

GKGideon KorenElectrophysiology

Discussion

Member takes

Implication

Residual stenosis after streptokinase reperfusion was associated with reocclusion; leaves open optimal post-reperfusion strategies in AMI.

Key Points

To evaluate clinical outcomes and coronary artery patency during a 3-month follow-up in patients receiving early intravenous streptokinase for acute myocardial infarction.
Prospective evaluation of 51 successive patients administered intravenous streptokinase at a mean of 1.7 ± 0.8 hours after acute myocardial infarction symptom onset.
Coronary angiography performed at 4 to 9 days post-admission, with a repeat late angiogram in 28 patients and clinical monitoring over a 3-month follow-up period.
Successful reperfusion was achieved in 41 patients, but only 25% of all 51 patients remained free of significant clinical cardiovascular manifestations, with angina occurring in 21, abnormal stress tests in 28, heart failure in 8, and reinfarction in 5.
Coronary revascularization (PTCA or CABG) was required in 15 of 41 (37%) reperfused patients, with a significantly higher intervention rate in those treated within 1 hour of symptom onset.
Patients with ≥60% residual stenosis in the infarct-related artery exhibited significantly higher rates of early reocclusion within 3 months and increased incidence of angina pectoris.

Structured PICO

Population

51 successive patients with acute myocardial infarction

Intervention

Intravenous streptokinase administered 1.7 +/- 0.8 hours after onset of symptoms

Outcome

Clinical cardiovascular manifestations (including angina pectoris, abnormal stress test, congestive heart failure, reinfarction, need for PTCA/CABG, and early reocclusion) during a three-month posthospital follow-up periodhard clinical

While early intravenous streptokinase achieves high reperfusion rates in acute myocardial infarction, patients with significant residual stenosis remain at high risk for ischemic symptoms and reocclusion, suggesting a need for early aggressive intervention.

Cite This Study

Gideon Koren (1987) studied this question.

synapsesocial.com/papers/6a110ba06da82ae745f33edf https://doi.org/10.1001/archinte.1987.00370020057036

Topics

Heart failure HFrEF treatment

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Implication

Residual stenosis after streptokinase reperfusion was associated with reocclusion; leaves open optimal post-reperfusion strategies in AMI.

Early Treatment of Acute Myocardial Infarction With Intravenous Streptokinase

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Early Treatment of Acute Myocardial Infarction With Intravenous Streptokinase

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider