Heparin and infarct coronary artery patency after streptokinase in acute myocardial infarction
| Autor: | Jerry W. Chandler, William P. Hood, L.Richard Smith, Russell C. Reeves, Patrick L. Whitlow, Edward F. Mahan, William A. Baxley, Hrudaya R. Nath, William J. Rogers |
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| Rok vydání: | 1990 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.drug_class Streptokinase medicine.medical_treatment Myocardial Infarction Coronary Angiography Internal medicine medicine Humans Thrombolytic Agent Thrombolytic Therapy cardiovascular diseases Myocardial infarction Vascular Patency Retrospective Studies Chemotherapy medicine.diagnostic_test Heparin business.industry Anticoagulant Angiography Middle Aged medicine.disease Coronary Vessels medicine.anatomical_structure cardiovascular system Cardiology Female Cardiology and Cardiovascular Medicine business Follow-Up Studies Artery medicine.drug |
| Zdroj: | The American Journal of Cardiology. 65:967-972 |
| ISSN: | 0002-9149 |
| DOI: | 10.1016/0002-9149(90)90998-g |
| Popis: | Anticoagulant therapy is frequently used after thrombolytic agents in the treatment of acute myocardial infarction (AMI) although it is unclear that such therapy will prevent subsequent infarct vessel reocclusion. The role of duration of heparin therapy in maintaining infarct artery patency was studied retrospectively in 53 consecutive AMI patients who received streptokinase therapy and underwent coronary angiography acutely and at 14 +/- 1 days. Of the 39 patients with initial infarct vessel patency, patency at follow-up angiography was observed in 100% (22 of 22) of those who received greater than or equal to 4 days of intravenous heparin but in only 59% (10 of 17) of those patients who received less than 4 days of heparin (p less than 0.05). Of the 14 patients not initially recanalized after streptokinase, patent infarct-related arteries at follow-up angiography were found in 3 of 8 (38%) treated with greater than or equal to 4 days of heparin therapy but in none of the 6 patients treated for less than 4 days (difference not significant). No significant difference in hemorrhagic complications was noted between the short- and long-term heparin treatment groups. Thus, greater than or equal to 4 days of intravenous heparin therapy after successful streptokinase therapy in AMI is more effective in maintaining short-term infarct vessel patency than a shorter duration of therapy and it may maintain the short-term patency of the infarct vessel in those patients who later spontaneously recanalize. |
| Databáze: | OpenAIRE |
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