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document
Prevention of subsequent exercise-induced periinfarct ischemia by emergency coronary angioplasty in acute myocardial infarction : comparison with intracoronary streptokinase . To compare the efficacy of emergency percutaneous transluminal coronary angioplasty and intracoronary streptokinase in preventing exercise-induced periinfarct ischemia , 28 patients presenting within 12 hours of the onset of symptoms of acute myocardial infarction were prospectively randomized . Of these , 14 patients were treated with emergency angioplasty and 14 patients received intracoronary streptokinase . Recatheterization and submaximal exercise thallium-201 single photon emission computed tomography were performed before hospital discharge . Periinfarct ischemia was defined as a reversible thallium defect adjacent to a fixed defect assessed qualitatively . Successful reperfusion was achieved in 86 % of patients treated with emergency angioplasty and 86 % of patients treated with intracoronary streptokinase ( p = NS ) . Residual stenosis of the infarct-related coronary artery shown at predischarge angiography was 43.8 +/- 31.4 % for the angioplasty group and 75.0 +/- 15.6 % for the streptokinase group ( p less than 0.05 ) . Of the angioplasty group , 9 % developed exercise-induced periinfarct ischemia compared with 60 % of the streptokinase group ( p less than 0.05 ) . Thus , patients with acute myocardial infarction treated with emergency angioplasty had significantly less severe residual coronary stenosis and exercise-induced periinfarct ischemia than did those treated with intracoronary streptokinase . These results suggest further application of coronary angioplasty in the management of acute myocardial infarction .
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Intervention_Physical
emergency coronary angioplasty
74230
Intervention_Physical
intracoronary streptokinase
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Intervention_Surgical
emergency percutaneous transluminal coronary angioplasty
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Intervention_Physical
intracoronary streptokinase
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Intervention_Physical
emergency angioplasty
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Intervention_Physical
intracoronary streptokinase
74235
Intervention_Physical
Recatheterization and submaximal exercise thallium-201 single photon emission computed tomography
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Intervention_Physical
emergency angioplasty
74237
Intervention_Physical
streptokinase
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Intervention_Physical
streptokinase
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Intervention_Physical
coronary angioplasty
74240
Outcome_Physical
exercise-induced periinfarct ischemia
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Outcome_Physical
Periinfarct ischemia
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Outcome_Physical
Successful reperfusion
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Outcome_Physical
Residual stenosis of the infarct-related coronary artery shown at predischarge angiography
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Outcome_Physical
exercise-induced periinfarct ischemia
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Outcome_Physical
severe residual coronary stenosis
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Outcome_Physical
exercise-induced periinfarct ischemia
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Participant_Condition
acute myocardial infarction :
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Participant_Condition
acute myocardial infarction
74249
Participant_Condition
acute myocardial infarction
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Participant_Condition
acute myocardial infarction