Limitation of myocardial infarction by early infusion of recombinant tissue-type plasminogen activator.

O'rourke, M. F.; Baron, D.; Keogh, Anne; Kelly, Raymond P.; Nelson, G.; Barnes, Chris; Raftos, John; Graham, Kevin J.; Hillman, Ken; H, Newman

doi:10.1161/01.cir.77.6.1311

Cited by 224 publications

(18 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The eligibility criteria for the study are described in detail elsewhere.21 In brief, the inclusion criteria were 1) chest pain of at least 30 minutes in duration, 2) electrocardiographic ST segment elevation of 0.1 mV or more in at least two leads, and 3) initiation of intravenous tissue-type plasminogen activator therapy within 4 hours of the onset of chest pain. There were 19 specific exclusion criteria for the TIMI trial, which were related primarily to contraindications to thrombolytic therapy.…”

Section: Study Populationmentioning

confidence: 99%

Feasibility of tomographic 99mTc-hexakis-2-methoxy-2-methylpropyl-isonitrile imaging for the assessment of myocardial area at risk and the effect of treatment in acute myocardial infarction.

et al. 1989

View full text Add to dashboard Cite

99mTc-hexakis-2-methoxy-2-methylpropyl-isonitrile (Tc-Sestamibi), a new myocardial perfusion radiopharmaceutical, was injected intravenously in 11 patients within 4 hours of the onset of acute myocardial infarction before treatment with intravenous tissue-type plasminogen activator and 6-14 days later. Five patients with acute myocardial infarction who did not receive intravenous thrombolytic therapy underwent a similar injection of radiopharmaceutical. The absence of redistribution of Tc-Sestamibi permitted imaging with single-photon emission computed tomography up to 6 hours after intravenous injection to assess the distribution of myocardial perfusion at the time of administration. The region of hypoperfused myocardium on the initial images varied widely from 9% to 68% of the left ventricle and was significantly greater in anterior than in inferior infarcts (p<0.01). The region of hypoperfused myocardium on the final images varied widely from 0% to 63% of the left ventricle and was also greater in anterior infarcts (p<0.01). The final hypoperfused region correlated (r=-0.82) with the late resting ejection fraction and with the late regional wall motion score in the infarct segment for both anterior (r=-0.74) and inferior (r=-0.97) infarcts. There was a significant decrease (-13±11%, p <0.003) in the extent of hypoperfused myocardium between the initial and final studies in the patients who received thrombolytic therapy compared with an insignificant increase (4±6%, p >0.5) in the patients who did not receive thrombolytic therapy. Toinographic imaging with Tc-Sestamibi permits determination of the amount of hypoperfused myocardium "at risk" in acute myocardial infarction. The change in myocardial perfusion determined by Tc-Sestamibi before and after therapy in acute myocardial infarction is a promising tool for assessing treatment.

show abstract

Section: Study Populationmentioning

confidence: 99%

Feasibility of tomographic 99mTc-hexakis-2-methoxy-2-methylpropyl-isonitrile imaging for the assessment of myocardial area at risk and the effect of treatment in acute myocardial infarction.

et al. 1989

View full text Add to dashboard Cite

show abstract

“…13) However, despite these deleterious effects of free radicals in the early stage of myocardial reperfusion, rapid restoration of coronary artery patency and salvage of threatened myocardium at the time of evolving myocardial infarction are the key aims in the management of AMI. Treatment with intravenous thrombolytic agents has been shown to result in improvement in both systolic function [14][15][16] and survival. 17,18) Despite considerable efforts to clarify the role of enzymatic defense against oxidant stress in human myocardial ischaemia/reperfusion, data on the activities of antioxidant enzymes in patients treated with thrombolysis for an AMI are still controversial.…”

mentioning

confidence: 99%

Time Course of Erythrocyte Antioxidant Activity in Patients Treated by Thrombolysis for Acute Myocardial Infarction.

Simić

Mimic-Oka²,

Pljesa³

et al. 2003

Jpn Heart J

View full text Add to dashboard Cite

SUMMARYThe deleterious effects of free radicals in acute myocardial ischaemia/reperfusion are rather well known. However, the possibility that thrombolysis positively affects the recovery of blood antioxidant capacity in the later postinfarction period, and thus contributes to the better overall outcome of these patients, has not yet been investigated.We followed the time course of erythrocyte antioxidant activity in 45 patients with first acute myocardial infarction (AMI), who were treated with streptokinase. Success of thrombolysis was evaluated by noninvasive clinical signs of reperfusion using continuous vector cardiography. The patients were divided into two groups according to successful or unsuccessful reperfusion. The control group consisted of 24 healthy subjects. Glutathione peroxidase (GPX) and superoxide dismutase (SOD) were determined immediately after admittance to the hospital (0 hours) and after subsequent thrombolytic therapy (1.5, 6, 12, and 24 hours after initiation of infusion of streptokinase), and 2, 4, and 8 days after AMI.Patients with AMI had decreased antioxidant enzyme activity at the time of admittance to the hospital, showing that the oxidative/antioxidative balance is disturbed early during the ischemic phase of AMI. In AMI patients without successful reperfusion, erythrocyte antioxidant enzyme activity remains low during the postinfarction period of 7 days. It can be concluded that prolonged ischemia reduces antioxidant enzyme activity. AMI patients with successful reperfusion have a significant rise in the activity of antioxidant enzymes within the first hours after thrombolysis, followed by a decrease until the third postinfarction day. During the subsequent postinfarction period, erythrocyte antioxidant activity gradually recovered and reached control levels. These beneficial effects of reperfusion on erythrocyte antioxidant status might contribute to the better overall prognosis of these patients. (Jpn Heart J 2003; 44: 823-832)

show abstract

“…A reduced incidence of death, reduced infarct size, and preservation of left ventricular function are wellestablished merits of pharmacologic thrombolytic therapy in acute myocardial infarction [13,14,15]. However, successful reperfusion occurs in only 70% of occluded coronary arteries [16], with many patients, as in the case presented here, having thrombi that resist systemic thrombolytic therapy.…”

Section: Discussionmentioning

confidence: 99%

Transluminal extraction catheter for acute myocardial infarction

Topaz

Miller

Vetrovec

1997

Cathet. Cardiovasc. Diagn.

View full text Add to dashboard Cite

Limitation of myocardial infarction by early infusion of recombinant tissue-type plasminogen activator.

Cited by 224 publications

References 11 publications

Feasibility of tomographic 99mTc-hexakis-2-methoxy-2-methylpropyl-isonitrile imaging for the assessment of myocardial area at risk and the effect of treatment in acute myocardial infarction.

Feasibility of tomographic 99mTc-hexakis-2-methoxy-2-methylpropyl-isonitrile imaging for the assessment of myocardial area at risk and the effect of treatment in acute myocardial infarction.

Time Course of Erythrocyte Antioxidant Activity in Patients Treated by Thrombolysis for Acute Myocardial Infarction.

Transluminal extraction catheter for acute myocardial infarction

Contact Info

Product

Resources

About