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  • Title: [Long-term follow-up of acute myocardial infarction after early intravenous streptokinase].
    Author: Gurevitch J, Mosseri M, Lotan C, Sapoznikov D, Gotsman MS.
    Journal: Harefuah; 1989 Jan 01; 116(1):6-11. PubMed ID: 2707666.
    Abstract:
    In a series of 30 patients with acute myocardial infarction (AMI) intravenous streptokinase was given within 4 hours of the onset of chest pain. Cardiac catheterization and angiography were performed on the 6th day, and again 4 months after the acute episode. Residual coronary artery stenosis increased significantly (from 84 +/- 3% to 95 +/- 7%, p less than 0.05) in those who had stenosis of more than 80% in infarct-related arteries. In this subgroup, a higher incidence of complete occlusion was found at the second investigation than in the other patients (p less than 0.002). Those who had received early treatment with streptokinase or had residual stenosis of less than 75% showed improvement in regional function of the infarct area, confirmed at the second angiography. End-systolic volume, regarded as a sensitive prognostic marker after myocardial infarction, correlated at the second investigation with residual coronary artery stenosis determined on day 6 (p less than 0.0016). Significant improvement in global ventricular function and return of regional function to normal was found in those who had received streptokinase within 2 hours of onset of pain, and in whom residual coronary artery stenosis was less than 75%. Early fibrinolytic treatment at the time of infarction is crucial for preservation of ventricular function and its later restoration. Coronary angiography 1 week after infarction detects high-risk patients who need early revascularization.
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