Why the study?
Does intravenous streptokinase treatment affect the results of early exercise testing in patients with first acute myocardial infarction?
Does intravenous streptokinase treatment affect the results of early exercise testing in patients with first acute myocardial infarction?
Early exercise test results in AMI patients are driven by infarct-related artery recanalization and multi-vessel disease rather than the administration of streptokinase itself.
Answers are grounded in this paper and cite their sources.
Early post-MI exercise test results may reflect recanalization status rather than streptokinase; leaves open independent treatment effects and requires prospective validation.
The aim of this study was to assess the value of the early exercise test (ET) in patients with acute myocardial infarction (AMI) treated with IV streptokinase (SK). The authors studied 70 patients with first AMI; 31 were treated with SK and 39 were not. Before discharge everyone was given early exercise up to 5-6 METs and catheterized within 22.9 +/- 7.2 days. There was no significant difference in the number of positive ETs between the two groups (11/31 and 14/39 respectively). There was significant difference in favor of: (1) the recanalization of the infarct-related artery in the SK group, (2) the negative ET in patients with recanalized vessels in both groups, (3) the positive ET in patients with multi-vessel coronary disease. It is concluded that the results of early ET in patients with AMI are related to the recanalization of the infarct-related artery and the coexistence of multi-vessel coronary artery disease, regardless of SK treatment. Patients with successful thrombolysis have negative ET more frequently.
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Hamouratidis et al. (1991) studied this question.
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