Selection of Patients with Acute Myocardial Infarction for Thrombolytic Therapy
Annals of Internal MedicinePublished 15 December 1990
David W.M. Muller, Eric J. Topol
Citations201
SJR quartileQ1
SJR score3.38
SNIP3.27
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
The data do not support the use of fibrinolytic therapy as primary treatment in patients with unstable angina or suspected myocardial infarction in the absence of confirmatory electrocardiographic changes, and the potential benefits of this treatment might be extended to selected high-risk subgroups.
Abstract
The full potential of thrombolytic therapy to alter the natural history of acute myocardial infarction can only be realized through the continued evaluation of selection criteria and the identification and treatment of the greatest possible number of eligible patients.
Keywords
Medicine
The LancetEFFECTIVENESS OF INTRAVENOUS THROMBOLYTIC TREATMENT IN ACUTE MYOCARDIAL INFARCTION
2,451 Citations1986GRUPPOITALIANOPERLOSTUDIODELL
HeartPlaque fissuring--the cause of acute myocardial infarction, sudden ischaemic death, and crescendo angina.
1,990 Citations1985Michael J. Davies, Anthony Thomas
This controversy was concerned with whether coronary artery thrombi were or were not directly responsible for all three clinical pictures of acute ischaemia.
CirculationThe wavefront phenomenon of ischemic cell death. 1. Myocardial infarct size vs duration of coronary occlusion in dogs.
1,926 Citations1977K A Reimer, J. E. Lowe +2 more
The results document the presence of a subepicardial zone of ischemic but viable myocardium which is available for pharmacologic or surgical salvage for at least three and perhaps six hours following circumflex occlusion in the dog.
New England Journal of MedicineAspirin, Heparin, or Both to Treat Acute Unstable Angina
1,278 Citations1988Pierre Théroux, Hélène Ouimet +11 more
It is concluded that in the acute phase of unstable angina, either aspirin or heparin treatment is associated with a reduced incidence of myocardial infarction, and there is a trend favoringHeparin over aspirin.
The LancetTRIAL OF TISSUE PLASMINOGEN ACTIVATOR FOR MORTALITY REDUCTION IN ACUTE MYOCARDIAL INFARCTION
1,157 Citations1988Robert G. Wilcox, Carl Olsson +5 more
Subset analysis showed that patients who had a normal electrocardiogram (ECG) at the time of randomisation had a low case fatality rate and rt-PA was associated with a 24.5% relative reduction in 1 month fatality.
New England Journal of MedicinePlatelet Activation in Unstable Coronary Disease
1,144 Citations1986Desmond J. Fitzgerald, Louis Roy +2 more
Data indicate that platelet activation occurs during spontaneous ischemia in patients with unstable angina, and the increment in prostacyclin biosynthesis during such episodes may be a compensatory response of vascular endothelium that limits the degree or effects of plateletactivation.
CirculationUnstable angina with fatal outcome: dynamic coronary thrombosis leading to infarction and/or sudden death. Autopsy evidence of recurrent mural thrombosis with peripheral embolization culminating in total vascular occlusion.
1,051 Citations1985Erling Falk
The period of unstable angina before the final heart attack was, in all but one of 15 patients, characterized by such an ongoing thrombotic process in a major coronary artery where recurrent mural thrombus formation seemed to have alternated with intermittentThrombus fragmentation.
New England Journal of MedicineComparison of Invasive and Conservative Strategies after Treatment with Intravenous Tissue Plasminogen Activator in Acute Myocardial Infarction
1,019 Citations1989The TIMI Study Group*
The ejection fraction and the incidence of death in the two groups were similar during the hospital period and total mortality within the first 6 days and at 42 days was also similar; the latter comparison was considered statistically significant according to the study criteria.
The LancetMEDICAL SCIENCE GISSI-2: A factorial randomised trial of alteplase versus streptokinase and heparin versus no heparin among 12 490 patients with acute myocardial infarction
911 Citations1990GRUPPOITALIANOPERLOSTUDIODELL
SK and tPA appear equally effective and safe for use in routine conditions of care, in all infarct patients who have no contraindications, with or without post-thrombolytic heparin treatment.
New England Journal of MedicineCoronary Angioscopy in Patients with Unstable Angina Pectoris
873 Citations1986CARL SHERMAN, Frank Litvack +11 more
It is concluded that angioscopy frequently reveals complex plaques or thrombi not detected by coronary angiography, which suggests that anginal syndromes that are refractory to medical treatment can be caused by unstable pathologic processes in the intima.
New England Journal of MedicineEffect of Intravenous Streptokinase on Left Ventricular Function and Early Survival after Acute Myocardial Infarction
620 Citations1987Harvey D. White, R M Norris +6 more
It is concluded that administration of intravenous streptokinase to patients with a first myocardial infarction results in improved left ventricular function and short-term survival.
European Heart JournalIntravenous and intracoronary fibrinolytic therapy in acute myocardial infarction: Overview of results on mortality, reinfarction and side-effects from 33 randomized controlled trials
571 Citations1985Salim Yusuf, Robert T. Collins +5 more
It may be several years before the net effects on mortality of any more widely practicable IV SK regimes can be agreed unless many of the hospitals that do not wish routinely to use IC regimes or the complex previous IV regimes will collaborate in multicentre randomized trials.
The LancetLONG-TERM EFFECTS OF INTRAVENOUS THROMBOLYSIS IN ACUTE MYOCARDIAL INFARCTION: FINAL REPORT OF THE GISSI STUDY
558 Citations1987GRUPPOITALIANOPERLOSTUDIODELL
Journal of the American College of CardiologyThe effect of diabetes mellitus on prognosis and serial left ventricular function after acute myocardial infarction: Contribution of both coronary disease and diastolic left ventricular dysfunction to the adverse prognosis
519 Citations1989Peter H. Stone, James E. Muller +10 more
The factors responsible for the increased incidence of adverse outcomes among diabetic patients may be related to an acceleration of the atherosclerotic process, diastolic left ventricular dysfunction associated with diabetic cardiomyopathy or other unidentified unfavorable processes.
JAMAThe Impact of Diabetes on Survival Following Myocardial Infarction in Men vs Women
481 Citations1988Robert D. Abbott
It is concluded that in the diabetic patient who survives an MI, cardiac failure is a common occurrence, warranting early detection and vigorous management in periods of convalescence and follow-up, particularly in women, where its effect on survivorship is considerable.
CirculationLimitation of myocardial infarct expansion by reperfusion independent of myocardial salvage.
454 Citations1987Judith S. Hochman, Hock‐Heng Choo
The results of this study in the rat preparation suggest a beneficial effect of "late" reperfusion on infarct expansion independent of myocardial salvage, which could mean the period after myocardIAL infarction during which a patient can be considered for thrombolytic therapy or reperfusions by percutaneous transluminal coronary angioplasty could be greatly prolonged.
CirculationIntravenous and intrapulmonary recombinant tissue-type plasminogen activator in the treatment of acute massive pulmonary embolism.
407 Citations1988M Verstraete, Graham Miller +7 more
Eight centers participated in a study in which intrapulmonary and intravenous administration of recombinant tissue-type plasminogen activator (rt-PA) were compared in 34 patients with acute massive pulmonary embolism.
CirculationRapid and sustained coronary artery recanalization with combined bolus injection of recombinant tissue-type plasminogen activator and monoclonal antiplatelet GPIIb/IIIa antibody in a canine preparation.
393 Citations1988Herman K. Gold, Barry S. Coller +7 more
The effects of bolus injections of recombinant single-chain tissue-type plasminogen activator (rt-PA) and of F(ab')2 fragments of a murine monoclonal antibody (7E3) against the human platelet GPIIb/IIIa receptor on coronary arterial thrombolysis and reocclusion was studied in a canine preparation of coronary artery thrombosis superimposed on high-grade stenosis.
New England Journal of MedicineFibrin and Fibrinogen-Related Antigens in Patients with Stable and Unstable Coronary Artery Disease
267 Citations1987Jonathan B. Kruskal, Patrick Commerford +2 more
The findings suggest the presence of an active thrombotic process in patients with unstable angina at rest or acute myocardial infarction, and are consistent with the hypothesis that thrombus formation may have an important role in the pathogenesis of these conditions.
CirculationThe Western Washington Intravenous Streptokinase in Acute Myocardial Infarction Randomized Trial.
245 Citations1988John W. Kennedy, G. V. Martin +5 more
It is concluded that patients with anterior myocardial infarction have improved survival when treated within the first 6 hr of symptoms, and patients with inferior infarctions do not appear to haveImproved survival with thrombolytic therapy.
CirculationAbolition of in vivo platelet thrombus formation in primates with monoclonal antibodies to the platelet GPIIb/IIIa receptor. Correlation with bleeding time, platelet aggregation, and blockade of GPIIb/IIIa receptors.
244 Citations1989Barry S. Coller, John D. Folts +3 more
It is concluded that in a significant percentage of animals, the extent of GPIIb/IIIa blockade required to prevent vasoocclusive thrombus formation in this model is less than that required for abolition of platelet aggregation, and that the preservation of only a minority of functional GP IIb/ IIIa receptors might be adequate to maintain a nearly normal bleeding time.
Annals of Emergency MedicineDelay between onset of chest pain and seeking medical care: The effect of public education
243 Citations1989Mary T Ho, Mickey S. Eisenberg +3 more
It is concluded that a short-duration education campaign may increase AMI knowledge but does not seem to significantly alter patient behavior.
CirculationFibrinopeptide A and platelet factor levels in unstable angina pectoris.
232 Citations1987Pierre Théroux, Jean-Gilles Latour +2 more
CirculationLimitation of myocardial infarction by early infusion of recombinant tissue-type plasminogen activator.
229 Citations1988M. F. O'Rourke, D. Baron +8 more
Left ventricular ejection fraction measured both by contrast and radionuclide ventriculography was higher in the rt-PA compared with the placebo group, indicating limitation of myocardial infarction by rT-PA.
Journal of the American College of CardiologyLong-term benefit of early thrombolytic therapy in patients with acute myocardial infarction: 5 year follow-up of a trial conducted by the Interuniversity Cardiology Institute of the Netherlands
220 Citations1989Maarten L. Simoons, Jeroen Vos +5 more
The salutary effects of thrombolytic therapy appear to be the result of myocardial salvage, particularly in patients with inferior wall infarction and those with greater than or equal to 90% stenosis of the infarct-related vessel at discharge.
The American Journal of CardiologyPrognosis of patients with diabetes mellitus after acute myocardial infarction
213 Citations1984Jay W. Smith, Gregory M. Marcus +1 more
Sixty patients with diabetes mellitus who survived the coronary care unit phase of acute myocardial infarction were followed an average of 19 months and the prognosis of diabetic patients was compared with that of 719 nondiabetic patients.
Journal of the American College of CardiologyA comprehensive analysis of myocardial infarction due to left circumflex artery occlusion: Comparison with infarction due to right coronary artery and left anterior descending artery occlusion
195 Citations1988Barry L. Huey, George Beller +2 more
Discriminate function analysis of all admission historical and ECG variables identified inferior and lateral ST elevation as independent predictors of circumflex artery-related infarction and multivessel disease.
The American Journal of CardiologyIntracoronary thrombus in nontransmural myocardial infarction and in unstable angina pectoris
187 Citations1983Jay B. Mandelkorn, Nelson M. Wolf +8 more
The finding of thrombolysis in several patients with nontransmural MI and UA suggests that intracoronary thrombus formation plays a pathogenetic role in some patients with these ischemic syndromes.
The American Journal of CardiologyPrognosis after acute myocardial infarction in patients with and without residual anterograde coronary blood flow
177 Citations1989Ricardo G. Cigarroa, Richard A. Lange +1 more
The incidence of long-term morbidity and mortality is greatly increased after AMI in patients without residual anterograde perfusion of the infarct-related coronary artery, and in these patients, the restoration of partial or complete anterogsrade flow--pharmacologically or mechanically--may be beneficial even if it is accomplished hours to days after the acute event.
CirculationThe role of intracoronary thrombus in unstable angina: angiographic assessment and thrombolytic therapy during ongoing anginal attacks.
174 Citations1988K Gotoh, Tohru Minamino +8 more
In patients with fixed obstructions, the rate-pressure product during active symptoms was significantly higher than during an asymptomatic period, indicating that a transient increase in myocardial oxygen demand may contribute to the ischemic attack in these patients.
The LancetEffect of heparin, aspirin, or alteplase in reduction of myocardial ischaemia in refractory unstable angina
171 Citations1990Gian Gastone Neri Serneri, Gian Franco Gensini +11 more
Heparin bolus and aspirin were not effective and heparin infusion significantly decreased the frequency of angina, episodes of silent ischaemia, and the overall duration ofIschaemia on the first days of treatment.
JAMAAn Analysis of Time Delays Preceding Thrombolysis for Acute Myocardial Infarction
166 Citations1989Scott W. Sharkey
It is concluded that significant in-hospital delays are likely to occur before a patient receives thrombolytic therapy for acute myocardial infarction, and a well-organized team approach to treatment will help to minimize delays in the implementation of this new form of therapy.
Journal of the American College of CardiologyEffects of early reperfusion in acute myocardial infarction on arrhythmias induced by programmed stimulation: A prospective, randomized study
165 Citations1986Ivo E. Kersschot, Pedro Brugada +7 more
This study compares inducibility of ventricular tachyarrhythmias by programmed electrical stimulation of the heart in patients with myocardial infarction with and without reperfusion after streptokinase therapy.
Annals of Internal MedicineCandidates for Thrombolysis among Emergency Room Patients with Acute Chest Pain
162 Citations1989Thomas H. Lee, Monica C. Weisberg +3 more
It is estimated that about 15% of patients with acute myocardial infarction would meet the criteria for eligibility for thrombolysis that have been used in clinical trials at the time of emergency room presentation, which could increase the positive predictive value to about 88% if eligibility were based on the official hospital electrocardiogram reading.
CirculationGlobal and regional left ventricular function and tomographic radionuclide perfusion: the Western Washington Intracoronary Streptokinase In Myocardial Infarction Trial.
156 Citations1984James L. Ritchie, Kathryn Davis +3 more
Journal of the American College of CardiologyElectrophysiologic effects of thrombolytic therapy in patients with a transmural anterior myocardial infarction complicated by left ventricular aneurysm formation
155 Citations1988Philip T. Sager, Robin A. Perlmutter +4 more
The LancetDISCREPANCIES BETWEEN THE EFFECTS OF CORONARY REPERFUSION ON SURVIVAL AND LEFT VENTRICULAR FUNCTION
152 Citations1989Frans Van de Werf
Les statistiques de survie a court et long terme et de fonction ventriculaire gauche apres traitement par thrombolyse de l'infarctus aigu montrent que les effets benefiques de the reperfusion coronarienne ne dependent pas seulement de the recuperation du myocarde ischemique.
CirculationMediation of reocclusion by thromboxane A2 and serotonin after thrombolysis with tissue-type plasminogen activator in a canine preparation of coronary thrombosis.
151 Citations1988Paolo Golino, J H Ashton +4 more
Whether reocclusion after thrombolysis is caused by intracoronary platelet aggregation and to determine the role of thromboxane A2 (TxA2) and serotonin (5HT) in mediating this phenomenon is determined.
CirculationA randomized, blinded, placebo-controlled trial of recombinant human tissue-type plasminogen activator in patients with unstable angina pectoris.
148 Citations1987H.K. Gold, Jennifer Johns +5 more
Twenty-four patients with unstable angina pectoris, defined as chest pain at rest with transient ST segment deviation of at least 1 mm, were randomly assigned to blinded treatment with either placebo or intravenous recombinant human tissue-type plasminogen activator (rt-PA).
American Heart JournalIntracoronary thrombolysis in syndromes of unstable ischemia: Angiographic and clinical results
147 Citations1982George W. Vetrovec, Robert C. Leinbach +2 more
Angiographic findings before and after thrombolysis in this preliminary study demonstrate a high frequency of intracoronary thrombus in preinfarction syndromes and suggest a decrease in angina frequency following thROMbolytic therapy.
CirculationWhich patients benefit most from early thrombolytic therapy with intracoronary streptokinase?
133 Citations1986Frank Vermeer, Maarten L. Simoons +8 more
Thrombolysis was most effective in patients admitted within 2 hr after onset of symptoms and in patients with a sum of ST segment elevation of 1.2 mV or more, and no beneficial effects of streptokinase on enzymatic infarct size, left ventricular function, or mortality were observed in the subset of patients.
Annals of Internal MedicineBleeding during Thrombolytic Therapy for Acute Myocardial Infarction: Mechanisms and Management
119 Citations1989David C. Sane, Robert M. Califf +4 more
An algorithm is developed for using cryoprecipitate, fresh frozen plasma, and platelets infusion with antifibrinolytic agents as a last alternative for hemorrhage and the role of platelet inhibition should be considered.
The American Journal of CardiologyPrognostic significance of the extent of myocardial injury in acute myocardial infarction treated by streptokinase (the GISSI trial)
114 Citations1989Francesco Mauri, Maurizio Gasparini +5 more
The extent of myocardial injury seems to be more relevant than the site in determining in-hospital mortality and efficacy of thrombolytic therapy.
Journal of the American College of CardiologySurvival and cardiac event rates in the first year after emergency coronary angioplasty for acute myocardial infarction
110 Citations1988Richard S. Stack, Robert M. Califf +12 more
Multivariable analysis identified the following factors as independent predictors of subsequent cardiovascular death: cardiogenic shock, greater age, lower ejection fraction, female gender and a closed infarct-related vessel on the initial coronary angiogram.
American Heart JournalLeft ventricular topographic alterations in the completely healed rat infarct caused by early and late coronary artery reperfusion
108 Citations1988Sharon L. Hale, Robert A. Kloner
Early reperfusion completely inhibited scar thinning and dilation of the LV cavity, maintaining normal LV topography and contributed to improved healing of the myocardium by resulting in a thicker scar.
The American Journal of CardiologyMortality and morbidity rates of patients older and younger than 75 years with acute myocardial infarction treated with intravenous streptokinase
107 Citations1987Allan S. Lew, Hanoch Hod +3 more
It is recommended that patients aged 75 years or older should not be routinely treated with intravenous streptokinase and heparin, and those from other studies reporting no reduction in mortality in elderly patients with AMI who are treated with IVSK are recommended.
Journal of the American College of CardiologyQuantitative and qualitative effects of intracoronary streptokinase in unstable angina and non-Q wave infarction
96 Citations1987John A. Ambrose, Craig E. Hjemdahl-Monsen +5 more
It is suggested that intracoronary streptokinase may be of limited utility in either unstable angina or recent non-Q wave infarction with a less than 100% occluded ischemia-producing artery.
Journal of the American College of CardiologyMulticenter trial of intravenous Anisoylated Plasminogen Streptokinase Activator Complex (APSAC) in acute myocardial infarction: Effects on infarct size and left, ventricular function
94 Citations1989Jean‐Pierre Bassand, J Machecourt +7 more
The early infusion of APSAC in acute myocardial infarction produced a high early patency rate, significant limitation of infarct size and significant preservation of left ventricular systolic function, mainly in anterior wall infarctions.
Annals of Internal MedicineIntracranial Hemorrhage after Use of Tissue Plasminogen Activator for Coronary Thrombolysis
93 Citations1990Carlos S. Kase, Angela M. O'Neal +3 more
Four patients died from massive intracranial hemorrhage; the mechanism for these hemorrhages was unclear and factors possibly related to hemorrhage include a systemic fibrinolytic state or a platelet anti-aggregant effect produced by tPA and enhanced hemorrhagic tendency caused by the combined effects of tPAand heparin.
The American Journal of CardiologyMechanism of acute myocardial infarction in patients with prior coronary artery bypass grafting and therapeutic implications
92 Citations1990Cindy L. Grines, David C. Booth +5 more
Data indicate that in patients who have undergone previous CABG, AMI is usually caused by thrombotic occlusion of a saphenous vein graft and that conventional intravenous thrombolytic therapy may be inadequate to restore flow.
Journal of the American College of CardiologyEffects of thrombolytic therapy in unstable angina: Clinical and angiographic results
91 Citations1988Chris de Zwaan, Frits W. Bär +4 more
A high incidence of coronary thrombosis in patients with unstable angina is suggested and better risk stratification and placebo-controlled prospective studies are required to obtain information on the risk/benefit ratio of thrombolytic therapy in unstableAngina.
Journal of the American College of CardiologyCommunity hospital administration of intravenous tissue plasminogen activator in acute myocardial infarction: Improved timing, thrombolytic efficacy and ventricular function
89 Citations1987Eric J. Topol, Eric R. Bates +9 more
As an investigational fibrinolytic agent for acute myocardial infarction, intravenous recombinant tissue-type plasminogen activator (rt-PA) has been administered primarily in tertiary care and university centers and the value of early initiation of such therapy was determined.
CirculationEffect of thromboxane and serotonin receptor antagonists on intracoronary platelet deposition in dogs with experimentally stenosed coronary arteries.
88 Citations1988Paolo Golino, L. Maximilian Buja +4 more
It is concluded that SQ 28668 and SQ 29548, two different TXA2 receptor antagonists, reduce residual intracoronary platelet deposition associated with CFVs in this canine model more effectively than ketanserin, a 5-HT2 receptor antagonist.
Journal of the American College of CardiologyCardiovascular complications of thrombolytic therapy in patients with a mistaken diagnosis of acute myocardial infarction
87 Citations1989James C. Blankenship, Adrian K. Almquist
Symptoms and electrocardiographic abnormalities mimicking acute myocardial infarction may be caused by non-coronary syndromes and treatment with thrombolytic agents may exacerbate the underlying disease process and produce cardiovascular complications.
CirculationSimultaneous administration of thromboxane A2- and serotonin S2-receptor antagonists markedly enhances thrombolysis and prevents or delays reocclusion after tissue-type plasminogen activator in a canine model of coronary thrombosis.
87 Citations1989Paolo Golino, J H Ashton +6 more
Thrombosis ResearchFibrinolytic therapy in unstable angina pectoris. A controlled clinical trial
80 Citations1980J. R. Lawrence, JamesT. Shepherd +3 more
The results suggest that the place of fibrinolytic therapy in persistently unstable angina merits further exploration, and the incidence of myocardial infarction per se was significantly less in the SK-treated group, but the lower mortality rate did not reach a level of statistical significance.
The American Journal of CardiologyEffect of early systemic thrombolytic therapy on left ventricular mural thrombus formation in acute anterior myocardial infarction
71 Citations1984Neal Eigler, Gerald Maurer +1 more
Early thrombolytic therapy with intravenous STK and heparin appears to significantly reduce the frequency of LV thrombus formation despite persistence of apical dyssynergy.
Journal of the American College of CardiologyDirect coronary angioplasty in acute myocardial infarction: Outcome in patients with single vessel disease
69 Citations1990Gregg W. Stone, Barry D. Rutherford +5 more
In patients with acute myocardial infarction and single vessel disease, coronary angioplasty without prior thrombolytic therapy can be performed with a high success rate and few procedural complications, resulting in an excellent early and late event-free survival.
The American Journal of CardiologyAdoption of thrombolytic therapy in the management of acute myocardial infarction
67 Citations1988Mark A. Hlatky, Harry E. Cotugno +4 more
A national survey of 1,065 physicians was carried out to document current use of thrombolytic therapy for acute myocardial infarction (AMI), with rapid acceptance in patients with short duration of symptoms or evidence of high risk.
Journal of the American College of CardiologyThe use of tissue-type plasminogen activator for acute myocardial infarction in the elderly: Results from thrombolysis in myocardial infarction phase I, open label studies and the thrombolysis in myocardial infarction phase II pilot study
62 Citations1989Bernard Chaitman, Bruce Thompson +7 more
The impact of age on hospital mortality, incidence of major hemorrhagic events and transfusion requirements was examined in 756 patients with acute myocardial infarction enrolled in the Thrombolysis in Myocardial Infarction (TIMI) Phase I, open label studies and the TIMI Phase II pilot study.
Journal of the American College of CardiologyRandomized, double-blind, placebo-controlled trial of tissue plasminogen activator in unstable angina
61 Citations1989John M. Nicklas, Eric J. Topol +6 more
To determine if thrombolysis could be beneficial when combined with maximal medical therapy, 40 patients with rest angina, angiographically documented coronary artery disease and pacing-induced ischemia were randomly assigned to intravenous recombinant tissue-type plasminogen activator (rt-PA, 150 mg/8 h) or placebo in a prospective doubleblind trial.
CirculationRelationship of the lytic state to successful reperfusion with standard- and low-dose intracoronary streptokinase.
54 Citations1985Robert L. Rothbard, Patricia G. Fitzpatrick +4 more
It is indicated that intrinsic properties of the thrombus influence the rate and outcome of treatment and that a minimal dose of SK is required to ensure lasting reperfusion in susceptible patients.
Journal of Pharmacology and Experimental TherapeuticsInfluence of selective endoperoxide/thromboxane A2 receptor antagonism with sulotroban on lysis time and reocclusion rate after tissue plasminogen activator-induced coronary thrombolysis in the dog.
50 Citations1988Ronald J. Shebuski, James M. Smith +3 more
The purpose of this investigation was to examine the potential beneficial effect of the selective endoperoxide/thromboxane A2 (TxA2) receptor antagonist, sulotroban (BM 13.177), on tissue type plasminogen activator (tPA)-induced coronary thrombolysis in the dog.
The American Journal of CardiologyImproved survival up to four years after early coronary thrombolysis
49 Citations1988Detlef G. Mathey, Joachim Schofer +6 more
Survival is improved up to 4 years after successful thrombolysis and appears to be further enhanced by early CABG, which is associated with a lower frequency of fatal reinfarction and cardiogenic shock in the CabG group.
Journal of the American College of CardiologyReperfusion therapy in inferior myocardial infarction
42 Citations1988Eric Bates
Patients with inferior infarction who present within 6 h of symptom onset with precordial ST segment depression should be considered candidates for intravenous thrombolytic therapy with rt-PA; immediate cardiac catheterization and possible coronary angioplasty should be limited to those who are in hemodynamically unstable condition.
HeartWhat proportion of patients with myocardial infarction are suitable for thrombolysis?
41 Citations1987N. Murray, Jennifer Lyons +2 more
The data suggest that treatment with intravenous streptokinase may be applicable to only a small proportion of patients with myocardial infarction.
American Heart JournalThromboxane synthetase inhibition with CGS 13080 improves coronary blood flow after streptokinase-induced thrombolysis
41 Citations1987Judith K. Mickelson, Paul J. Simpson +2 more
The focus of this investigation was to examine the potential beneficial effects of the selective thromboxane synthetase inhibitor CGS 13080 (imidazo [1,5-a] pyridine-5-hexanoic acid) on coronary blood flow after streptokinase-induced thrombolysis.
Thrombosis ResearchEffect of thromboxane synthase inhibition on the thrombolytic action of tissue-type plasminogen activator in a rabbit model of peripheral arterial thrombosis
35 Citations1988Ronald J. Shebuski, Barbara L. Storer +1 more
Data indicate that thromboxane synthase inhibition may be beneficial as an adjunct to thrombolytic therapy with tPA, and pretreatment with CGS 13080 resulted in a greater than 10-fold enhancement in the effective dose of tPA.
The LancetELIGIBILITY FOR THROMBOLYTIC THERAPY IN ACUTE MYOCARDIAL INFARCTION
32 Citations1987Jacqui Jagger, M.K. Davies +3 more
Fibrinolysis and ProteolysisSignificance of antibodies to streptokinase in coronary thrombolytic therapy with streptokinase or APSAC
29 Citations1988Johannes J.M.L. Hoffmann, Robin Fears +4 more
The present clinical results show that the reperfusion response in the population of patients was not significantly affected by IgG anti-SK at therapeutic doses of intravenous APSAC or intracoronary SK, while the systemic lytic state was significantly influenced by anti- SK antibodies.
HeartFatal intrathoracic haemorrhage after cardiopulmonary resuscitation and treatment with streptokinase and heparin.
21 Citations1989Glenn Haugeberg, Vernon Bonarjee +1 more
A 66 year old man with acute myocardial infarction underwent cardiopulmonary resuscitation before being treated with streptokinase and heparin, but died of an intrathoracic haemorrhage caused by multiple fractures of the sternum and ribs.
Journal of the American College of CardiologyTreatment of life-threatening ventricular arrhythmias with nonguided surgery supported by electrophysiologic testing and drug therapy
20 Citations1989Chi-Sung Zee-Cheng, Nicholas T. Kouchoukos +2 more
High risk patients who undergo nonguided surgery for life-threatening ventricular arrhythmia and left ventricular aneurysm have a relatively low surgical mortality and a better long-term survival than previously reported.
The American Journal of CardiologyEarly intravenous thrombolytic therapy for acute myocardial infarction in patients with prior coronary artery bypass grafts
19 Citations1989Neal S. Kleiman, David A. Berman +3 more
5 cases of successful thrombolysis using recombinant tissue plasminogen activator (rt-PA) in patients who had previously undergone coronary bypass surgery are reported, indicating an increasing number of AMIs in this group can be anticipated.
The American Journal of CardiologyAcute myocardial infarction complicating recanalization of aortocoronary bypass grafts with urokinase therapy
18 Citations1989Louis S. McKeever, Joseph R. Hartmann +10 more
3 cases of thrombolytic recanalization of occluded aortocoronary bypass grafts complicated by acute myocardial infarction are reported, and it is strongly suggested that the need for continued urokinase infusion is critical in the treatment of this potential complication.
The American Journal of CardiologyAcute intervention during myocardial infarction in patients with prior coronary bypass surgery
17 Citations1990Kevin M. Kavanaugh, Eric J. Topol
The experience in the treatment of patients after coronary artery bypass surgery in the setting of evolving myocardial infarction was reviewed and the efficacy of acute intervention as defined by infarct-related vessel patency after intervention was estimated.
Journal of the American College of CardiologyTissue plasminogen activator: why the backlash?
17 Citations1989Eric J. Topol, Robert M. Califf
Steinkopff eBooksPlatelet activation in unstable angina
17 Citations1989Carlo Patrono, Margarita Véjar
These reconstructions show that both deep and superficial intimai injury can invoke thombus formation, and that plaque fissures with overlying mural thrombi are the morphological basis of angiographic type II lesions.
Annals of Emergency MedicineA community survey of the potential use of thrombolytic agents for acute myocardial infarction
15 Citations1989Mickey S. Eisenberg, Mary T Ho +5 more
Clinicians should apply restrictive criteria to potential candidates for thrombolytic therapy until liberal criteria (therapy up to 24 hours and ST depression) are convincingly shown to be of benefit.
…