Results of high dose intravenous urokinase for acute myocardial infarction
| Autor: | David C. Whitcomb, Depak Pasi, Kristina N. Sigmon, Jane M. Boswick, Richard S. Stack, Lynne Aronson, Harry R. Phillips, Don Chaplin, Mark Zawodniak, Moosa Hajisheik, Walter Barker, Susan Mantell, Michael DiMeo, Thomas C. Wall, Robert M. Califf, Richard Tenney, Sadanaud Hegde |
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| Rok vydání: | 1990 |
| Předmět: |
medicine.medical_specialty
Heart Ventricles medicine.medical_treatment Myocardial Infarction Coronary Disease Hemorrhage Recurrence Angioplasty medicine Humans Vascular Patency Prospective Studies Myocardial infarction Angioplasty Balloon Coronary Infusions Intravenous Prospective cohort study Aged Urokinase Chemotherapy medicine.diagnostic_test business.industry Heart Middle Aged medicine.disease Urokinase-Type Plasminogen Activator Surgery Bypass surgery Angiography Cardiology and Cardiovascular Medicine business Follow-Up Studies medicine.drug |
| Zdroj: | The American Journal of Cardiology. 65:124-131 |
| ISSN: | 0002-9149 |
| DOI: | 10.1016/0002-9149(90)90072-9 |
| Popis: | To determine the outcome of patients after treatment with high-dose intravenous urokinase (3 million U) 102 patients were prospectively evaluated in the setting of acute myocardial infarction. The first 61 patients received intravenous urokinase as a continuous infusion and the last 41 patients were treated with an initial 1.5 million U intravenous bolus. Sixty-two percent of all patients had patent infarct-related arteries by the time of immediate angiography (median time 2.2 hours), which was performed in all patients. There was no significant difference in patency rates between patients treated with or without an initial intravenous bolus. Twenty-eight (28%) patients developed clinical evidence of recurrent ischemia (death, reocclusion, emergency angioplasty, urgent bypass surgery) during hospitalization, whereas only 7 (7%) developed angiographically documented reocclusion. Of 28 patients who failed to achieve successful reperfusion at the time of immediate catheterization, rescue angioplasty was technically successful in establishing reperfusion in all but 1 patient. No significant improvement in median global left ventricular function was seen between immediate (48%) and follow-up catheterization (48%). Significant bleeding complications were unusual except in 1 patient who experienced an intracranial hemorrhage. Eight (8%) patients died during hospitalization. Therefore, the use of high-dose intravenous urokinase in patients with acute myocardial infarction is associated with a 62% patency rate, a low incidence of reocclusion and bleeding complications and a high technical success rate with rescue angioplasty at the time of immediate catheterization.(ABSTRACT TRUNCATED AT 250 WORDS) |
| Databáze: | OpenAIRE |
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