Intracoronary prostaglandin E1 plus streptokinase in acute myocardial infarction

Sharma, B; Wyeth, Richard P.; Gimenez, H.; Franciosa, Joseph A.

doi:10.1016/0002-9149(86)90375-9

Cited by 48 publications

(4 citation statements)

References 28 publications

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“…Es findet Anwendung u. a. zum Offenhalten des Ductus arteriosus bei Neugeborenen, erektilen Dysfunktionen, im Rahmen der koronaren Herzkrankheit bei akuter Myokardischämie (z. B. intrakoronare Applikation mit Streptokinase) (27,(35)(36)(37)(38) und chronischer Herzinsuffizienz im NYHA-Stadium III/IV (auch anderer Genese). Seit Anfang der 90er Jahre wird es insbesondere bei Patienten, die auf der Warteliste zur Herztransplantation stehen, zum "Bridging" eingesetzt, wenn die konservative Therapie mit Digitalis, ACE-Hemmern, Saluretika und/oder adrenergen Substanzen sowie neuerdings Beta-Blockern nur unzureichenden Erfolg hat (1).…”

Section: Diskussionunclassified

Hämodynamische Effekte einer einmaligen intravenösen Applikation von Prostaglandin E1 bei einem Patientenkollektiv mit chronischer Herzinsuffizienz im NYHA-Stadium II/III

Schrader

Erbel

Wittlich³

et al. 1998

Z Kardiol

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We investigated the hemodynamic effects of a single infusion of PGE1 (60 micrograms infused over a period of 2 h--this is the single dose used in courses of treatment for peripheral occlusive arterial disease) in patients with chronic heart failure NYHA class II-III. The ejection fraction of these patients was < 55%, their average age was 58.4 years (standard deviation 10 years), and their condition was stable. Nineteen of the patients had coronary heart disease and one patient had myocarditis. The hemodynamic data were obtained invasively by catheterization of the right and left heart. Blood pressure and pulse rate were measured manually. Intravenous infusion of 60 micrograms PGE1 over a period of 2 hours did not significantly alter contractility or hemodynamics. Dp/dtmax, dp/dtmax/p, and dp/dt DP40, which are parameters of left ventricular contractility, determined with the aid of a catheter-tip manometer, did not differ significantly over time from those in the placebo control group. Similarly, the other data furnished no evidence that administration of PGE1 had any hemodynamic or myocardial effects. Hence, it is reasonable to state that it is safe to administer PGE1 to patients with peripheral occlusive arterial disease.

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Section: Diskussionunclassified

Hämodynamische Effekte einer einmaligen intravenösen Applikation von Prostaglandin E1 bei einem Patientenkollektiv mit chronischer Herzinsuffizienz im NYHA-Stadium II/III

Schrader

Erbel

Wittlich³

et al. 1998

Z Kardiol

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“…In other pilot studies, hemodynamic improvements were seen in patients with angina pectoris and acute myocardial infarction [54,55]. To ascertain whether PGE~ causes coronary steal, Feldmann et al [56] used coronary angiography to compare the effect of intravenous and intracoronary infusions of PGE~ with the effect of intracoronary injection of glyceryl trinitrate in patients with coronary heart disease.…”

Section: Cardiac Effectsmentioning

confidence: 99%

Cardiopulmonary effects and safety of prostaglandin E₁: A review

Heidrich¹,

Breddin²,

Rudofsky³

et al. 1994

Int J Angiol

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“…Consequently, several different approaches have been suggested to reduce the incidence of rethrombosis. These include (a) the thrombolytic approach, extending the duration of therapy to improve the extent of reperfusion (29); (b) the antithrombotic approach, employing either anticoagulants (27,48) or aspirin (17) or both (1 14); (c) the vasodilator approach utilizing nitroglycerin (83), isosorbide dinitrate (35), or prostaglandin El with its prostacyclinlike action (dilatation and platelet inhibition) (95); and (d) the mechanical or surgical approach, i.e., angioplasty (19,65,94, 1 10) or coronary by-pass surgery (5). At present, the most popular approach has been to combine anticoagulation with early angioplasty, but this may not be the final word.…”

Section: Rethrombosismentioning

confidence: 99%

Thrombolytic Agents for Acute Myocardial Infarction

Sherry

1988

Cardiovascular Drug Reviews

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There are five agents [streptokinase (SK), anisoylated plasminogen-streptokinase complex (APSAC), urokinase (UK), recombinant tissue plasminogen activator (rt-PA), and pro-urokinase (r pro-UK)] that have been under evaluation for the treatment of an acute evolving myocardial infarction. All are either indirect or direct activators of plasminogen; they all convert the latter to the proteolytic enzyme plasmin by cleaving the ATg560-Va1561 bond; and all, when used properly, are effective in dissolving recent thrombi and emboli. Each has advantages and disadvantages, but none have established their superiority over the others as yet. This conclusion, while dependent on incomplete data and subject to change, is based on their comparative effects when administered intravenously in patients with acute evolving myocardial infarctions. STREPTOKINASE (SK)Streptokinase, the bacterial protein that reacts immediately on a one-to-one basis with human plasminogen to form a potent and very efficient plasminogen activator, is the least expensive of the agents. The earlier it is administered after the onset of the symptoms of a myocardial infarction, the higher is the frequency of reperfusion (2, 4,2 1,40, 50,7 1,9 1, 106, 1 1 1, 1 15). During the most critical period, i.e., the first 3 h, a reasonable estimate is 65% (100, 104). Great difficulties exist in accurately establishing the incidence or adequacy of reperfusion associated with the administration of thrombolytic agents intravenously during the first 3 h following symptom onset. The estimate given is based primarily on reperfusion rates observed with post-treatment angiograms only (2, 4, 50, 91, 11 1). Pretreatment angiograms were not done in all but one of these studies since the procedure, when added to the time of amval at the catheterization laboratory following symptom onset, prohibits treatment of the vast majority of patients within the first 3 h. The use of angiography, while currently the best method for measuring perfusion, has serious limitations: in the presence of a pathologic process with ongoing necrosis it does not measure flow rates or its adequacy or the efficacy of the more distal perfusion, and the observations are made at

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Intracoronary prostaglandin E1 plus streptokinase in acute myocardial infarction

Cited by 48 publications

References 28 publications

Hämodynamische Effekte einer einmaligen intravenösen Applikation von Prostaglandin E1 bei einem Patientenkollektiv mit chronischer Herzinsuffizienz im NYHA-Stadium II/III

Hämodynamische Effekte einer einmaligen intravenösen Applikation von Prostaglandin E1 bei einem Patientenkollektiv mit chronischer Herzinsuffizienz im NYHA-Stadium II/III

Cardiopulmonary effects and safety of prostaglandin E₁: A review

Thrombolytic Agents for Acute Myocardial Infarction

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Intracoronary prostaglandin E1 plus streptokinase in acute myocardial infarction

Cited by 48 publications

References 28 publications

Hämodynamische Effekte einer einmaligen intravenösen Applikation von Prostaglandin E1 bei einem Patientenkollektiv mit chronischer Herzinsuffizienz im NYHA-Stadium II/III

Hämodynamische Effekte einer einmaligen intravenösen Applikation von Prostaglandin E1 bei einem Patientenkollektiv mit chronischer Herzinsuffizienz im NYHA-Stadium II/III

Cardiopulmonary effects and safety of prostaglandin E1: A review

Thrombolytic Agents for Acute Myocardial Infarction

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Cardiopulmonary effects and safety of prostaglandin E₁: A review