Title

Myocardial Infarction Management With Peripheral Streptokinase

Comments

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Abbreviated Journal Title

Ann. Emerg. Med.

Keywords

Planning & Development

Abstract

The early management of myocardial infarction (MI) is undergoing a new evolution. Aggressive treatment and new invasive modalities have brought improved prognosis to these patients. Intracoronary administration of fibrinolytic agents is rapidly gaining wide acceptance. We report a pilot protocol for administration of peripheral intravenous (IV) versus direct intracoronary fibrinolytic agents in acute MI. Thirty patients with acute evolving MI were assigned consecutively to receive fibrinolytic therapy; 15 patients received intracoronary streptokinase and 15 received peripheral IV streptokinase at a dosage of 1.5 million units over a 30-minute period. Evaluation by clinical symptoms, ECG changes, and hemodynamic studies by angiography and radionuclide ventriculography indicated comparable and beneficial results for both groups. Patients assigned to the IV therpay were able to receive streptokinase therapy 1.5 hours earlier than those receiving intracoronary therapy, and they had a higher incidence of reperfusion. We conclude that IV streptokinase therapy may be preferable to intracoronary therapy in view of a higher reperfusion frequency, fewer complications, and greater ease of administration. With both treatment modalities, comparable improvement in left ventricular function was noted. Institutions that do not have invasive techniques available may well be the first to benefit from this method of myocardial salvage, and we encourage cooperation between emergency and cardiology departments.

Journal Title

Annals of Emergency Medicine

Volume

13

Issue/Number

1007

Publication Date

1-1-1984

Document Type

Article

Language

English

First Page

1000

Last Page

1964

WOS Identifier

WOS:A1984TP38600002

ISSN

0196-0644

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