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  • Title: [Intravenous thrombolysis in acute myocardial infarct. Clinical and angiography results in 124 patients and the significance of early revascularization].
    Author: Leisch F, Schützenberger W, Kerschner K, Harringer W, Hofmann R, Herbinger W.
    Journal: Wien Med Wochenschr; 1987 Jun 15; 137(10-11):224-9. PubMed ID: 2955575.
    Abstract:
    124 patients with evolving acute myocardial infarction received high-dose intravenous streptokinase (1.5 Mio U within 60 min i.v.). Hospital mortality was 4% and 11% of the patients suffered from a streptokinase-related complication (most frequent bleeding problems). All complications could be treated medically. The angiographic control in 111 patients (90%) after a mean of 11 +/- 8 days after thrombolysis demonstrated a patent antegrade perfused infarct-artery in 85 patients (77%). From the first 55 patients only 16% had a revascularization procedure. An early revascularization in 39 patients (57%) of the last 69 patients reduced the reinfarction rate from 15 to 7%. The hospital mortality was not influenced (3.6 vs 4.3%). High-dose i.v. streptokinase-application is associated with low treatable complication rates and clinically relevant reperfusion rates. An early revascularization (coronary angioplasty, bypass-surgery) reduces the reinfarction rate to about 50% and improves left ventricular function.
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