This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Meyer, J. Articles by Effert, S. Search for Related Content PubMed PubMed Citation Articles by Meyer, J. Articles by Effert, S.

Circulation, Vol 66, 905-913, Copyright © 1982 by American Heart Association

ARTICLES

Percutaneous transluminal coronary angioplasty immediately after intracoronary streptolysis of transmural myocardial infarction

J Meyer, W Merx, H Schmitz, R Erbel, T Kiesslich, R Dorr, H Lambertz, C Bethge, W Krebs, P Bardos, C Minale, BJ Messmer and S Effert

Percutaneous transluminal coronary angioplasty (PTCA) was performed in 21 patients with acute myocardial infarction (AMI) treated by intracoronary infusion of streptokinase within 8 hours after the onset of symptoms. Streptolysis therapy began a mean of 3.6 +/- 1.2 hours (+/- SD) after the onset of symptoms. The vessel was occluded in 14 patients and highly stenosed in seven. After the infusion of 67,300 +/- 63,200 IU of streptokinase over 26.1 +/- 21.5 minutes, patency of the occluded vessels was reached. PTCA as performed 20-60 minutes after the end of streptokinase treatment in 19 patients and 24 and 31 hours after treatment in two patients. The dilation was successful in 17 patients (81%). The degree of vessel obstruction was reduced from 90.2 +/- 7.3% to 58.6 +/- 19.5% (area method) and from 71.4 +/- 12.4% to 39.2 +/- 19.7% (diameter method). The improvement was 31.5 +/- 18.4% and 32.2 +/- 19.3%, respectively. No reocclusion was induced by PTCA. Twenty patients were discharged. One died during hospitalization; at autopsy, the treated vessel was still patent. During the follow-up period, two reinfarctions and one asymptomatic reocclusion occurred. The clinical findings during the hospital course and the follow-up period were compared with those of a control group of 18 patients with AMI and comparable coronary stenoses who were treated only with streptokinase infusion. Four of these patients had a reinfarction during the hospital course, and three died during the follow-up period. PTCA can be performed safely and successfully immediately after intracoronary infusion of streptokinase in patients with AMI. By reducing the subtotal stenosis, this treatment contributes to the reperfusion of the ischemic myocardium, diminishes the risk of a reocclusion and seems to improve the prognosis.

This article has been cited by other articles:

				T. Hayashi, M. Taniguchi, A. Kimura, M. Miyataka, A. Kurooka, T. Taniwa, T. Kiyoshima, M. Matsuura, N. Takeda, H. Nakamura, et al. Efficacy of Coronary Angioplasty Following Conventional Coronary Thrombolysis in Patients with Acute Myocardial Infarction Angiology, September 1, 2004; 55(5): 507 - 515. [Abstract] [PDF]

				T. J. Ryan The Coronary Angiogram and Its Seminal Contributions to Cardiovascular Medicine Over Five Decades Circulation, August 6, 2002; 106(6): 752 - 756. [Full Text] [PDF]

				S. B. King III Angioplasty From Bench to Bedside to Bench Circulation, May 1, 1996; 93(9): 1621 - 1629. [Full Text]

				H. Asonuma, Y. Tanji, H. Nakatoh, T. Nakajima, H. Akita, A. Sasaki, and K. Shoji Successful Direct PTCA on LAD after First Episode of Acute Myocardial Infarction: Does It Improve Cardiac Function? Angiology, September 1, 1990; 41(9): 724 - 730. [Abstract] [PDF]

				G. Koren, M. H. Luria, A. T. Weiss, M. Kriwisky, M. Mosseri, C. Lotan, D. Applebaum, S. Welber, D. Sapoznikov, Y. Ben-David, et al. Early Treatment of Acute Myocardial Infarction With Intravenous Streptokinase: A High-Risk Syndrome Arch Intern Med, February 1, 1987; 147(2): 237 - 240. [Abstract] [PDF]

				P. L. Zwerner and J. M. Gore Analytic Review: Thrombolytic Therapy in Acute Myocardial Infarction J Intensive Care Med, December 1, 1986; 1(6): 302 - 318. [Abstract] [PDF]

				E. J. TOPOL, W. R. BELL, and M. L. WEISFELDT Coronary Thrombolysis with Recombinant Tissue-Type Plasminogen Activator: A Hematologic and Pharmacologic Study Ann Intern Med, December 1, 1985; 103(6_Part_1): 837 - 843. [Abstract] [PDF]

				Thrombolysis for Evolving Myocardial Infarction Ann Intern Med, September 1, 1985; 103(3): 463 - 469. [Abstract] [PDF]

				J. Y. Wei, J. E. Markis, M. Malagold, and W. Grossman Time Course of Serum Cardiac Enzymes After Intracoronary Thrombolytic Therapy: Creatine Kinase, Creatine Kinase MB Isozyme, Lactate Dehydrogenase, and Serum Glutamic-Oxaloacetic Transaminase Arch Intern Med, September 1, 1985; 145(9): 1596 - 1600. [Abstract] [PDF]

				J. H. Stein, M. B. Weiss, J. H. Ro, and M. V. Herman Percutaneous Transluminal Coronary Angioplasty of a Coronary Artery With a Total Occlusion Arch Intern Med, September 1, 1984; 144(9): 1875 - 1877. [Abstract] [PDF]