| Title | Supplementary thrombolysis for refractory myocardial infarction | |
| Authors | Ioannis E. Kanonidis¹, Constantine L. Papadopoulos¹, Stelios C. Savatis¹, Eleni G. Kokkali¹, Athanasios Platis¹, Sevasti Sakalerou¹, Basil A. Kokkas², Constantine Th. Gitsios¹ and George C. Sakadamis¹
1. 2nd Cardiology Department and 2. Laboratory of Pharmacology, Aristotle University, Thessaloniki, Greece |
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| Citation | Kanonidis, I.E., Papadopoulos, C.L., Savatis, S.C., Kokkali, E.G., Platis, A. et al.: Supplementary thrombolysis for refractory myocardial infarction, Epitheorese Klin. Farmakol. Farmakokinet. 12(3): 31-37 (1998) | |
| Publication Date | Received for publication: 15 October 1997
Accepted for publication. 20 October 1997 |
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| Full Text Language | English | |
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| Keywords | Acute Myocardial infarction, thrombolytic drugs, patients, statistical study. | |
| Other Terms | Statistical study | |
| Summary | The study aims to evaluate the effect of supplementary infusion of thrombolytic drugs in patients with Acute Myocardial infarction who were refractory to the initial treatment at standard doses. The study includes 42 patients, 28 with anterior and 14 with inferior acute myocardial infarction to whom the initial treatment failed. Initial treatment involved streptokinase (SK) (1,500,000 U/45 min) in 17 patients and rtPA (10 mg bolus followed by 90 mg/90 min) in 25 patients. Supplementary infusion involved the same thrombolytic drugs in half the initial dose (that is SK 750,000U/30 min and rtPA 50 mg/30 min). Reperfusion was evaluated one hour after completion of the initial and the supplementary thrombolytic administration by noninvasive methods that is: a) relief of pain, b) resolution of ST segment elevation in all initially affected leads by at least 20% compared to basal (pretreatment) values. Coronary angiography was done at 7-10 days to all patients who survived. Supplementary infusion resulted in regression of ischaemia in 14 cases, 8 with anterior and 6 with inferior infarction (37.5%). Six patients died (4 anterior, 1 posterior). Coronary angiography confirmed vessel patency in 10 of the 14 successful cases. In the remaining 22 patients, coronary angiography showed total occlusion in 18 cases (12 with anterior and 6 with inferior infarction). A lytic state (Fibrinogen <0.5 g%) was noticed in all patients after the supplementary infusion. No major bleeding complications were noticed clinically. In conclusion, supplementary infusion is relatively safe. It seems to partially improve patency rates in refractory inferior acute myocardial infarction but has not any appreciable effect on anterior infarctions. | |
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