Which patients benefit most from early thrombolytic therapy with intracoronary streptokinase

摘要: The effect of thrombolysis in acute myocardial infarction on enzymatic infarct size, left ventricular function, and early mortality was studied subsets patients a randomized trial. Early thrombolytic therapy with intracoronary streptokinase (152 patients) or preceded by intravenous (117 compared conventional treatment (264 patients). All 533 were admitted to the coronary care unit within 4 hr after onset symptoms indicative infarction. Four hundred eighty-eight eligible for this detailed analysis, 245 these allocated 243 treatment. angiographic examinations performed 212 therapy. Patency infarct-related artery achieved 181 (85%). Enzymatic as measured from cumulative alpha-hydroxybutyrate dehydrogenase release, smaller (median 760 vs 1170 U/liter control patients, p = .0001). Left ejection fraction radionuclide angiography before discharge hospital higher 50% 43% Three month lower (6% 14% group, .006). With use multivariate regression size limitation, improvement fraction, three predicted sum ST segment elevation, time admission, Killip class at admission. Thrombolysis most effective 2 elevation 1.2 mV more. On other hand, no beneficial effects observed subset less than who between symptoms.