Key result
RCA recanalization with streptokinase is linked to ~100% resolution of reciprocal anterior ST depression.
Why the study?
The mechanism underlying anterior ST segment depression during acute inferior myocardial infarction was unclear.
Observational (n=17)
Interventional study reveals anterior ST segment depression resolves with reperfusion in acute inferior myocardial infarction, indicating reciprocal change rather than anterior ischemia.
Anterior ST segment depression, found in 13 of 17 patients with acute inferior myocardial infarctions, resolved promptly in all 11 patients whose occluded right coronary arteries were opened with an infusion of streptokinase. Failure of streptokinase to open the artery produced no change in the electrocardiogram. Five of the patients with anterior ST segment depression had normal left anterior descending coronary arteries. In the other patients opening the right coronary artery normalized the anterior ST segments without resulting in collateral flow to the anterior wall, or changing blood pressure or heart rate. Anterior ST depression was a manifestation of the inferior infarction and was not due to anterior ischemia.
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William C. Little (1984) conducted an observational in Acute inferior myocardial infarction (n=17). Streptokinase infusion vs. Failure to open occluded right coronary artery was evaluated on Resolution of anterior ST segment depression. Opening occluded right coronary arteries with streptokinase resolved anterior ST segment depression in 100% of successfully treated patients (11/11), without producing anterior collateral flow.
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