ECG and enzymatic indicators of therapeutic success after intravenous streptokinase for acute myocardial infarction
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ECG and enzymatic indicators of therapeutic success after intravenous streptokinase for acute myocardial infarction. / Clemmensen, P; Grande, P; Pedersen, F; Granborg, J; Svendsen, Jesper Hastrup; Madsen, J K; Haedersdal, C; Saunamäki, K.
In: American Heart Journal, Vol. 120, No. 3, 01.09.1990, p. 503-9.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - ECG and enzymatic indicators of therapeutic success after intravenous streptokinase for acute myocardial infarction
AU - Clemmensen, P
AU - Grande, P
AU - Pedersen, F
AU - Granborg, J
AU - Svendsen, Jesper Hastrup
AU - Madsen, J K
AU - Haedersdal, C
AU - Saunamäki, K
PY - 1990/9/1
Y1 - 1990/9/1
N2 - Thrombolytic therapy has been documented to result in reperfusion of jeopardized myocardium and reduction in the size of the acute myocardial infarction (AMI). The effect of intravenous streptokinase on a creatine kinase-MB (CK-MB) reperfusion index and an ECG estimate of myocardial salvage was therefore studied in 65 patients with a first AMI, randomized to treatment with streptokinase (n = 33) or placebo (control group, n = 32). Reperfusion was defined as a CK-MB appearance rate constant (k1) greater than 0.185. The final AMI size was first predicted from the admission standard ECG by previously developed formulas based on ST segment elevation. The final AMI size was estimated from the QRS score on the predischarge ECG. Myocardial salvage was defined as a greater than or equal to 20% decrease from predicted to final AMI size. The k1 value in the control group was significantly lower than that in the streptokinase group (median 0.157 versus 0.328; p = 0.0001). Accordingly the reperfusion rate was higher in the streptokinase group than in the control group (88% versus 34%; p = 0.0002). The difference in AMI size (final-predicted) was significantly greater in the streptokinase group than in the control group (median -7% versus +1%; p = 0.0001). Myocardial salvage occurred in 60% and 19%, respectively (p = 0.004). A significant correlation was found between CK-MB reperfusion and ECG salvage: 19 of 20 streptokinase-treated patients with salvage also had reperfusion.(ABSTRACT TRUNCATED AT 250 WORDS)
AB - Thrombolytic therapy has been documented to result in reperfusion of jeopardized myocardium and reduction in the size of the acute myocardial infarction (AMI). The effect of intravenous streptokinase on a creatine kinase-MB (CK-MB) reperfusion index and an ECG estimate of myocardial salvage was therefore studied in 65 patients with a first AMI, randomized to treatment with streptokinase (n = 33) or placebo (control group, n = 32). Reperfusion was defined as a CK-MB appearance rate constant (k1) greater than 0.185. The final AMI size was first predicted from the admission standard ECG by previously developed formulas based on ST segment elevation. The final AMI size was estimated from the QRS score on the predischarge ECG. Myocardial salvage was defined as a greater than or equal to 20% decrease from predicted to final AMI size. The k1 value in the control group was significantly lower than that in the streptokinase group (median 0.157 versus 0.328; p = 0.0001). Accordingly the reperfusion rate was higher in the streptokinase group than in the control group (88% versus 34%; p = 0.0002). The difference in AMI size (final-predicted) was significantly greater in the streptokinase group than in the control group (median -7% versus +1%; p = 0.0001). Myocardial salvage occurred in 60% and 19%, respectively (p = 0.004). A significant correlation was found between CK-MB reperfusion and ECG salvage: 19 of 20 streptokinase-treated patients with salvage also had reperfusion.(ABSTRACT TRUNCATED AT 250 WORDS)
KW - Creatine Kinase
KW - Echocardiography
KW - Electrocardiography
KW - Heart
KW - Heart Ventricles
KW - Humans
KW - Injections, Intravenous
KW - Isoenzymes
KW - Myocardial Infarction
KW - Myocardial Reperfusion
KW - Streptokinase
M3 - Journal article
C2 - 2389686
VL - 120
SP - 503
EP - 509
JO - American Heart Journal
JF - American Heart Journal
SN - 0002-8703
IS - 3
ER -
ID: 32477074