Thrombolytic therapy for acute myocardial infarction: evaluation of a selective approach to invasive diagnosis and therapy in a community hospital
| Autor: | Edward C. Keating, J. R. Calder, John M. Burks, J. C. Kirby |
|---|---|
| Rok vydání: | 1990 |
| Předmět: |
Adult
Male medicine.medical_specialty Cardiac Catheterization medicine.medical_treatment Streptokinase Myocardial Infarction Infarction Hospitals Community Revascularization Angina Electrocardiography Recurrence Internal medicine Myocardial Revascularization Medicine Humans Thrombolytic Therapy Myocardial infarction Angioplasty Balloon Coronary Coronary Artery Bypass Aged business.industry General Medicine Thrombolysis Middle Aged medicine.disease Community hospital Surgery Survival Rate Regimen Cardiology Female Cardiology and Cardiovascular Medicine business medicine.drug Follow-Up Studies |
| Zdroj: | Clinical cardiology. 13(6) |
| ISSN: | 0160-9289 |
| Popis: | To investigate the effectiveness of selective catheterization and revascularization after thrombolytic therapy for myocardial infarction, we studied the early and late clinical course of 100 consecutive patients treated with streptokinase and an intensive medical regimen. Catheterization was performed because of recurrent angina or evidence for reperfusion and myocardial salvage. Fifty-six patients were catheterized, and 37 underwent revascularization. Hospital mortality was 8%. Among the 92 hospital survivors, after 1 year follow-up there was no significant difference between the revascularized and nonrevascularized groups in total survival (97% and 100%, respectively) or in infarct-free survival (97% and 95%, respectively). During total follow-up of 34 (+/- 13) months, late clinical events (death, reinfarction, late revascularization, and severe angina) occurred in 16% of 37 revascularized patients and in 27% of 55 patients not revascularized (p = 0.31). Cumulative hospital and late survival for the entire group was 91% at 1 year and 86% at final evaluation. Excellent long-term survival and a low incidence of recurrent infarction may be achieved after thrombolytic therapy, using selective catheterization and revascularization based on widely available clinical estimates of further ischemic risk. |
| Databáze: | OpenAIRE |
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