The Risk of Stroke in Patients with Acute Myocardial Infarction after Thrombolytic and Antithrombotic Treatment
New England Journal of MedicinePublished 2 July 1992
Aldo P. Maggioni, M. G. Franzosi, Eugenio Santoro, Harvey D. White, Frans Van de Werf, Gianni Tognoni
Citations283
SJR quartileQ1
SJR score19.08
SNIP13.47
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TL;DR
Patients with acute myocardial infarction who receive thrombolytic therapy have a small risk of stroke, whereas a higher body-mass index or a history of hypertension, diabetes, or smoking did not.
Abstract
Patients with acute myocardial infarction who receive thrombolytic therapy have a small risk of stroke. Treatment with t-PA as compared with streptokinase resulted in a small but significant excess of stroke. Subcutaneous heparin, given together with t-PA or streptokinase and aspirin, did not result in an increased risk of stroke.
Keywords
Medicine
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620 Citations1990The International Study Group
In a study with 2 x 2 factorial design, 20,891 patients with suspected acute myocardial infarction of less than 6 h duration were randomly allocated to alteplase (recombinant tissue plasminogen activator, tPA) or streptokinase (SK) and to subcutaneous Heparin, beginning 12 h after the start of thrombolytic therapy or no heparin.
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583 Citations1981Richard Asinger, Frank L. Mikell +2 more
It is concluded that patients with severe apical-wall-motion abnormalities during acute transmural anterior myocardial infarction are at high risk for left-ventricular thrombosis and this high-risk group can be identified before the development of left-volatile thrombi.
CirculationImmediate versus deferred beta-blockade following thrombolytic therapy in patients with acute myocardial infarction. Results of the Thrombolysis in Myocardial Infarction (TIMI) II-B Study.
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Clinical and pathologic data suggested an embolic etiology for most strokes that complicate acute myocardial infarction, including peak creatine kinase and ventricular arrhythmia.
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129 Citations1978Pauline Thompson, James S. Robinson
Two-thirds of the patients with acute myocardial infarction had negligible risk of stroke and did not need anticoagulant prophylaxis, suggesting that the peak enzyme values reflected infarct size.
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94 Citations1990Christopher M. O'Connor, M. Califf +10 more
Thirteen (1.8%) of 708 patients with acute myocardial infarction treated with recombinant tissue-type plasminogen activator in the Thrombolysis and Angioplasty in Myocardial Infarction I, II and III trials developed a stroke.
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75 Citations1991Aldo P. Maggioni, M.G. Franzosi +5 more
Although the incidence of cerebrovascular events complicating myocardial infarction was low, they increased morbidity and mortality and age and poor haemodynamic state were associated with an increased risk.
BMJBattle of the clotbusters.
24 Citations1991Martin O’Donnell
The data came from investigators in nearly 1 000 hospitals in Europe, North America, and Australasia who had treated over 46 000 patients suffering an acute myocardial infarction with one of three randomly assigned fibrinolytic agents : streptokinase, anistreplase, or tissue plasminogen activator (tPA).
