Late thrombolytic therapy preserves left ventricular function in patients with collateralized total coronary occlusion: primary end point findings of the Second Mount Sinai-New York University Reperfusion Trial.

摘要: The change in left ventricular ejection fraction from preintervention to predischarge was prospectively assessed 393 patients with acute myocardial infarction. Within 12 h of symptom onset (mean 6.3 ± 2.7 h), were randomly assigned a double-blind intracoronary infusion streptokinase, nitroglycerin, both streptokinase and nitroglycerin or conventional therapy without cardiac catheterization. Treatment effects also defined angiographic subsets. There significant interaction between (p < 0.01), resulting an increase 3.9 percentage units the combined treatment arm 0.001). Patients collateral flow totally obstructed infarct-related artery showed improvement over those (5.4 2.5%) streptokinase-nitroglycerin (10.6 %) arms, but not arm. Time did influence fraction. In initial subtotal occlusion, thrombolytic no short-term benefit because increased by 6% all three intervention arms. These findings indicate that relatively late results salvage collateralized total coronary occlusion. This is potentiated concomitant therapy.