EFFECTS OF EARLY ADMINISTRATION OF A HIGHLY PURIFIED HYALURONIDASE PREPARATION (GL ENZYME) ON MYOCARDIAL INFARCT SIZE
| Autor: | Michael M. Webb-Peploe, D.J. Coltart, D N Croft, S. Saltissi, P S Robinson |
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| Rok vydání: | 1982 |
| Předmět: |
Male
medicine.medical_specialty Myocardial Infarction Hyaluronoglucosaminidase Infarction Hemodynamics Chest pain Placebo Gastroenterology Electrocardiography Necrosis Random Allocation Double-Blind Method Internal medicine Humans Medicine cardiovascular diseases Myocardial infarction Vein chemistry.chemical_classification Diminution Clinical Trials as Topic business.industry Myocardium Heart General Medicine Middle Aged medicine.disease Enzyme medicine.anatomical_structure chemistry Anesthesia Injections Intravenous Female medicine.symptom business |
| Zdroj: | The Lancet. 319:867-871 |
| ISSN: | 0140-6736 |
| DOI: | 10.1016/s0140-6736(82)92148-1 |
| Popis: | 79 patients with suspected myocardial infarction entered a randomised trial to establish the safety of early intravenous administration of a highly purified hyaluronidase preparation (GL enzyme) and to assess its effects on eventual infarct size as measured by electrocardiographic, enzymatic, and scintigraphic criteria. Of the 71 patients with infarction, 35 received GL enzyme and 36 placebo within 6 h of the onset of chest pain. GL enzyme injected into a peripheral vein produced no adverse changes in the clinical, haemodynamic, biochemical, or haematological variables studied. GL enzyme reduced precordial electrocardiographic indices of infarct size as reflected by a diminution (p less than 0.02) in the degree of both R wave loss and Q wave development. In addition, the number of leads developing pathological Q waves (N delta Q greater than or equal to 2), a sign of progression from ischaemia to necrosis, was reduced (p less than 0.05) after GL enzyme treatment. However, there were no significant differences in infarct size as measured by cumulative creatine kinase MB isoenzyme release or technetium-99m pyrophosphate scintigraphic infarct area, or in clinical outcome during the hospital stay. Interpretation of the enzymatic and scintigraphic data was complicated by chance bias in pre-treatment randomisation which resulted in more (p less than 0.05) patients with severe haemodynamic impairment (and hence probably larger infarct sizes) entering the GL enzyme group. Nonetheless, a favourable effect of GL enzyme on infarct size was demonstrated by precordial electrocardiographic QRS mapping, here each patient acts as his or her own control. |
| Databáze: | OpenAIRE |
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