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document
Variability of thrombolytic coronary reperfusion : an angiographic study of streptokinase and anistreplase . A total of 1,615 angiographic readings in 240 patients with acute myocardial infarction were analyzed from a randomized trial of intravenous anistreplase ( Eminase ) , also known as anisoylated plasminogen streptokinase activator complex ( APSAC ) , versus intracoronary streptokinase . Coronary arteriography was performed at baseline and at 15 , 30 , 45 , 60 , 75 , and 90 minutes after drug infusion . Coronary flow in the infarct-related artery was defined using the TIMI criteria . Some serial change in perfusion was noted in 25 % of the total patient population and in 49 % of all reperfusion patients . Complete loss of perfusion ( grade 2 or 3 to grade 0 or 1 ) occurred in 35 % of all reperfused patients . Half of these patients ultimately developed complete loss of perfusion at the study endpoint . All of these changes in flow were statistically more common for the circumflex coronary artery and early treatment ( less than 4 h ) , but did not differ for anistreplase or streptokinase . We conclude that frequent alterations in coronary blood flow occur early during reperfusion therapy and that these findings may explain reports with varying results of thrombolytic therapy . Any angiographic assessment of thrombolytic drug efficacy should take these variations as well as interobserver variability into account .
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Intervention_Physical
thrombolytic coronary reperfusion
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Intervention_Physical
streptokinase
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Intervention_Physical
anistreplase
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Intervention_Physical
intravenous anistreplase ( Eminase ) , also known as anisoylated plasminogen streptokinase activator complex ( APSAC )
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Intervention_Physical
streptokinase
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Intervention_Physical
anistreplase
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Intervention_Physical
streptokinase
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Intervention_Psychological
reperfusion therapy
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Intervention_Psychological
thrombolytic therapy
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Intervention_Pharmacological
thrombolytic drug
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Outcome_Physical
serial change in perfusion
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Outcome_Physical
Complete loss of perfusion
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Outcome_Physical
loss of perfusion
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Outcome_Physical
alterations in coronary blood flow
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Participant_Sample-size
240
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Participant_Condition
acute myocardial infarction