Skip to main content
NCBI home page
Journal of the National Medical Association logoLink to Journal of the National Medical Association
letter
. 1988 Sep;80(9):978–983.

Aggressive Management of Acute Myocardial Infarction

Keith C Ferdinand
PMCID: PMC2625862  PMID: 2977190

Abstract

Acute transmural myocardial infarction is usually caused by a coronary thrombus along with fixed coronary artery stenosis. Myocardial necrosis can be interrupted by the prompt use of pharmacologic and mechanical thrombolysis. Intravenous streptokinase and urokinase have been associated with approximately a 45 percent recanalization rate while the newer agent, recombinant human tissue-type plasminogen activator (rt-PA), has an average lysis rate of 70 percent intravenously. Intracoronary streptokinase and urokinase have a similar 75 percent lysis rate, but with additional costs and morbidity. Percutaneous transluminal angioplasty (PTCA) is often indicated to correct an underlying stenosis, the time of which depends on the experience and expertise of the PTCA team.

Full text

PDF
978

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. De Feyter P. J., van Eenige M. J., van der Wall E. E., Bezemer P. D., van Engelen C. L., Funke-Kupper A. J., Kerkkamp H. J., Visser F. C., Roos J. P. Effects of spontaneous and streptokinase-induced recanalization on left ventricular function after myocardial infarction. Circulation. 1983 May;67(5):1039–1044. doi: 10.1161/01.cir.67.5.1039. [DOI] [PubMed] [Google Scholar]
  2. DeWood M. A., Spores J., Notske R. N., Lang H. T., Shields J. P., Simpson C. S., Rudy L. W., Grunwald R. Medical and surgical management of myocardial infarction. Am J Cardiol. 1979 Dec;44(7):1356–1364. doi: 10.1016/0002-9149(79)90453-3. [DOI] [PubMed] [Google Scholar]
  3. DeWood M. A., Spores J., Notske R., Mouser L. T., Burroughs R., Golden M. S., Lang H. T. Prevalence of total coronary occlusion during the early hours of transmural myocardial infarction. N Engl J Med. 1980 Oct 16;303(16):897–902. doi: 10.1056/NEJM198010163031601. [DOI] [PubMed] [Google Scholar]
  4. EHRLICH J. C., SHINOHARA Y. LOW INCIDENCE OF CORONARY THROMBOSIS IN MYOCARDIAL INFARCTION. A RESTUDY BY SERIAL BLOCK TECHNIQUE. Arch Pathol. 1964 Oct;78:432–445. [PubMed] [Google Scholar]
  5. Gold H. K., Leinbach R. C., Garabedian H. D., Yasuda T., Johns J. A., Grossbard E. B., Palacios I., Collen D. Acute coronary reocclusion after thrombolysis with recombinant human tissue-type plasminogen activator: prevention by a maintenance infusion. Circulation. 1986 Feb;73(2):347–352. doi: 10.1161/01.cir.73.2.347. [DOI] [PubMed] [Google Scholar]
  6. Kennedy J. W., Ritchie J. L., Davis K. B., Fritz J. K. Western Washington randomized trial of intracoronary streptokinase in acute myocardial infarction. N Engl J Med. 1983 Dec 15;309(24):1477–1482. doi: 10.1056/NEJM198312153092402. [DOI] [PubMed] [Google Scholar]
  7. O'Neill W., Timmis G. C., Bourdillon P. D., Lai P., Ganghadarhan V., Walton J., Jr, Ramos R., Laufer N., Gordon S., Schork M. A. A prospective randomized clinical trial of intracoronary streptokinase versus coronary angioplasty for acute myocardial infarction. N Engl J Med. 1986 Mar 27;314(13):812–818. doi: 10.1056/NEJM198603273141303. [DOI] [PubMed] [Google Scholar]
  8. Ong L., Reiser P., Coromilas J., Scherr L., Morrison J. Left ventricular function and rapid release of creatine kinase MB in acute myocardial infarction. Evidence for spontaneous reperfusion. N Engl J Med. 1983 Jul 7;309(1):1–6. doi: 10.1056/NEJM198307073090101. [DOI] [PubMed] [Google Scholar]
  9. Raizner A. E., Tortoledo F. A., Verani M. S., Van Reet R. E., Young J. B., Rickman F. D., Cashion W. R., Samuels D. A., Pratt C. M., Attar M. Intracoronary thrombolytic therapy in acute myocardial infarction: a prospective, randomized, controlled trial. Am J Cardiol. 1985 Feb 1;55(4):301–308. doi: 10.1016/0002-9149(85)90365-0. [DOI] [PubMed] [Google Scholar]
  10. Rentrop K. P., Blanke H., Karsch K. R., Kreuzer H. Initial experience with transluminal recanalization of the recently occluded infarct-related coronary artery in acute myocardial infarction -- comparison with conventionally treated patients. Clin Cardiol. 1979 Apr;2(2):92–105. doi: 10.1002/clc.4960020203. [DOI] [PubMed] [Google Scholar]
  11. Schröder R., Biamino G., von Leitner E. R., Linderer T., Brüggemann T., Heitz J., Vöhringer H. F., Wegscheider K. Intravenous short-term infusion of streptokinase in acute myocardial infarction. Circulation. 1983 Mar;67(3):536–548. doi: 10.1161/01.cir.67.3.536. [DOI] [PubMed] [Google Scholar]
  12. Sigwart U., Goy J. J., Finci L., Blanc M., Grbic M., Stumpe F. Mechanical emergency recanalization of the left main coronary artery. Clin Cardiol. 1986 May;9(5):217–220. doi: 10.1002/clc.4960090510. [DOI] [PubMed] [Google Scholar]
  13. The Thrombolysis in Myocardial Infarction (TIMI) trial. Phase I findings. TIMI Study Group. N Engl J Med. 1985 Apr 4;312(14):932–936. doi: 10.1056/NEJM198504043121437. [DOI] [PubMed] [Google Scholar]
  14. Tillett W. S., Garner R. L. THE FIBRINOLYTIC ACTIVITY OF HEMOLYTIC STREPTOCOCCI. J Exp Med. 1933 Sep 30;58(4):485–502. doi: 10.1084/jem.58.4.485. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Topol E. J., Califf R. M., George B. S., Kereiakes D. J., Abbottsmith C. W., Candela R. J., Lee K. L., Pitt B., Stack R. S., O'Neill W. W. A randomized trial of immediate versus delayed elective angioplasty after intravenous tissue plasminogen activator in acute myocardial infarction. N Engl J Med. 1987 Sep 3;317(10):581–588. doi: 10.1056/NEJM198709033171001. [DOI] [PubMed] [Google Scholar]
  16. Van de Werf F., Ludbrook P. A., Bergmann S. R., Tiefenbrunn A. J., Fox K. A., de Geest H., Verstraete M., Collen D., Sobel B. E. Coronary thrombolysis with tissue-type plasminogen activator in patients with evolving myocardial infarction. N Engl J Med. 1984 Mar 8;310(10):609–613. doi: 10.1056/NEJM198403083101001. [DOI] [PubMed] [Google Scholar]
  17. Yusuf S., Collins R., Peto R., Furberg C., Stampfer M. J., Goldhaber S. Z., Hennekens C. H. Intravenous and intracoronary fibrinolytic therapy in acute myocardial infarction: overview of results on mortality, reinfarction and side-effects from 33 randomized controlled trials. Eur Heart J. 1985 Jul;6(7):556–585. doi: 10.1093/oxfordjournals.eurheartj.a061905. [DOI] [PubMed] [Google Scholar]

Articles from Journal of the National Medical Association are provided here courtesy of National Medical Association

RESOURCES