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September 1, 1983Clinical Cardiology

High dose intravenous streptokinase in acute myocardial infarction

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Key result

High dose intravenous streptokinase infusion achieved early recanalization in 60% of patients with acute myocardial infarction and angiographically proven total occlusion.

Why the study?

Does brief high dose intravenous streptokinase infusion achieve early recanalization in patients with acute myocardial infarction and angiographically proven total occlusion?

Population

40 patients with acute myocardial infarction (AMI) and angiographically proven total occlusion

Design

Cohort

Follow-up

18 +/- 8 months

Authors

KNK. L. NeuhausKliniken der Stadt KölnUTUlrich TebbeInterventional / Structural CardiologyGSG. SauerDartmouth–Hitchcock Medical Center

Discussion

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Implication

May support high-dose IV streptokinase for recanalization in AMI; leaves open need for randomized confirmation before practice change.

Key Points

  • This research aims to evaluate the effectiveness of high dose intravenous streptokinase for early recanalization in patients with acute myocardial infarction.
  • 40 patients with acute myocardial infarction and total occlusion received high dose intravenous streptokinase infusion.
  • The infusion rate was 30,000 to 40,000 IU/min, with measurement of myocardial enzyme creatine phosphokinase.
  • Patients were divided into recanalization (group A) and non-recanalization (group B) based on outcomes after treatment.
  • Recanalization was achieved in 24 patients (60%) in group A after a mean time of 48 +/- 14 min.
  • In group A, left ventricular ejection fraction increased from 55 +/- 9% to 58 +/- 10%, while in group B it decreased from 49 +/- 11% to 41 +/- 11%, with p<0.005.
  • Follow-up over 18 months indicated significant outcomes and no serious bleeding related to treatment.

Study Design

Type

Observational (n=40)

Structured PICO

Does brief high dose intravenous streptokinase infusion achieve early recanalization in patients with acute myocardial infarction and angiographically proven total occlusion?

P
Population
40 patients with acute myocardial infarction and angiographically proven total occlusion treated with high dose intravenous streptokinase, followed for a mean of 18 months.
I
Intervention
Brief high dose intravenous streptokinase infusion (IVSK) at an infusion rate of 30,000 to 40,000 IU/min (total dose ~1.7 Mio IU)
O
Outcome
Early recanalization of infarct-related coronary arteriessurrogate

High-dose intravenous streptokinase is an effective and safe method for achieving early coronary recanalization in the majority of patients with acute myocardial infarction.

Cite This Study

Neuhaus et al. (1983) conducted an observational in Acute myocardial infarction (AMI) (n=40). High dose intravenous streptokinase infusion (IVSK) was evaluated on Early recanalization of infarct-related coronary arteries. High dose intravenous streptokinase infusion achieved early recanalization in 60% of patients with acute myocardial infarction and angiographically proven total occlusion.

synapsesocial.com/papers/6a2043313f2ec568b1df62a8https://doi.org/10.1002/clc.4960060903
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Also Consider

Synapse has enriched 3 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Acute myocardial infarction: Intracoronary application of nitroglycerin and streptokinase1979 · 411 citations
  2. 2The fibrin plate method for estimating fibrinolytic activity1952 · 1,703 citations
  3. 3Myocardial Salvage after Intracoronary Thrombolysis with Streptokinase in Acute Myocardial Infarction1981 · 278 citations