scholarly journals Clinical effectiveness of thrombolytic therapy with alteplase and double antiplatelet therapy in acute myocardial infarction

2011 ◽  
Vol 10 (6) ◽  
pp. 59-63
Author(s):  
D. N. Kuznetsov ◽  
V. V. Trusov ◽  
I. A. Kazakova
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Thrombolytic Therapy ◽  
Clinical Effectiveness ◽  
Minute Volume ◽  
Myocardial Salvage ◽  
Group I ◽  
General Weakness ◽  
Number Of Patients ◽  
Group Ii

Aim. To assess the clinical effectiveness of thrombolytic therapy (TLT) with alteplase in patients with acute myocardial infarction (AMI). Material and methods. The study included 54 AMI patients, divided into two groups: Group I (n=26), which underwent TLT, and Group II (n=28), which had contraindications to TLT. The TLT method was an accelerated alteplase infusion. Both groups were comparable by age and sex. In all patients, AMI biomarker levels and echocardiography (EchoCG) parameters were measured. Results. Successful thrombolysis was performed in 19 patients (73 %). The mean “symptom-to-needle” time was 3,7±0,6 hours. In Groups I and II, the 50 % reduction in the ST segment deviation from isoelectric line at 180 minutes was observed in 34,6 % and 0 % of the patients, respectively. In addition, in Group I, there was a reduction in the number of patients complaining of general weakness, dyspnoea, and recurrent angina attacks. The levels of cardio-specific AMI biomarkers were higher in Group II. According to the EchoCG results at 10 days after admission, the Group I patients demonstrated higher minute volume (by 28,8 %), higher ejection fraction (by 30 %), and higher end-diastolic dimension (by 23,8 %). Conclusion. The results obtained confirm high effectiveness of the in-hospital TLT with accelerated alteplase infusion. Alteplase therapy was associated with clinical and morphological myocardial salvage in AMI patients.

scholarly journals Detection and Characterization of Prevotella Intermedia and Its In Vitro Susceptibility to Selected Antimicrobial Agents in Chronic Periodontitis and Acute Myocardial Infarction

2019 ◽  
Vol 3 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Deepa Anumala ◽  
Mohan Kumar Pasupuleti ◽  
Ravindra Reddy Nagireddy
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chronic Periodontitis ◽  
Antimicrobial Agents ◽  
Prevotella Intermedia ◽  
Causative Role ◽  
In Vitro Susceptibility ◽  
Group Iii ◽  
Group I ◽  
Group Ii

Background: Periodontal disease has been reported to play a causative role in acute myocardial infarction (AMI), which may add to the various risk factors associated with coronary heart disease. The objective of the present study was to investigate the presence of Prevotella intermedia – an established periodontal pathogen – in subgingival plaque samples of chronic periodontitis and AMI patients in order to identify a possible association, and to evaluate the susceptibility of Prevotella intermedia to nine antimicrobial agents. Methods: After undergoing screening for eligibility, a total of 50 subjects were included in the present study. Twenty patients were diagnosed with AMI and generalized chronic periodontitis (Group I), 20 patients were diagnosed with only AMI (Group II), and 10 subjects were healthy controls (Group III). The isolated Prevotella intermedia strains were tested for susceptibility to bacitracin, chloramphenicol, penicillin G, polymyxin, gentamycin, neomycin, tetracycline, cefotaxime, and cefoxitin using an antibiotic zonescale to determine minimum inhibitory concentrations (MICs). Results: Periodontal pathogens were identified by phenotypic and enzymatic methods. The mean bacterial load of Prevotella intermedia species was higher in Group I compared to Group II and Group III. It was also found that pencillin G, gentamycin, neomycin, tetracycline, cefotaxime, and cefoxitin inhibited 90% of Prevotella intermedia, whereas bacitracin, chloramphenicol, and polymyxin inhibited 80% of Prevotella intermedia. Thus, only 10% of Prevotella intermedia were resistant to these antibiotics. Conclusion: The present study confirms that Prevotella intermedia is associated with chronic periodontitis and AMI.

PROTECTIVE EFFECT OF CARNITINE (ST-261, SIGMA-TAU) IN ACUTE MYOCARDIAL INFARCTION IN DOGS

1987 ◽  
Author(s):  
K Kordenat ◽  
J Leasure
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Protective Effect ◽  
Myocardial Necrosis ◽  
Control Group ◽  
Computer Technique ◽  
T Wave ◽  
Group I ◽  
The Mean ◽  
Group Ii

Limitation of infarct size (IS), using ST-261, was evaluated in a group (I) of eight dogs, during acute MI. Another group (II) served as the control group. The protocol for both groups was the same except that each dog in the treated group was ST-261 as a single bolus (25 mg/kg, in 20ml normal saline), before inducing an occluding thrombus in the mid-LAD, using a closed-chest model, under x-ray visualization. Percentages of total (gms) myocardium at jeopardy (TMJW) and myocardial necrosis (TMNW), delineated by fluoroscein and TTC dyes, respectively, were calculated and compared to the total ventricular myocardial weight (TVMU), by computer technique for both groups at 3 Hrs post-occlusion of the LAD. Mean serum total CPK (CPK-t) and isozymes (mb-band) were measured before and up to 3 Hrs post-occlusion, as were various hemodynamic and mean precordial (21 lead) ST-segment and T-wave amplitudes. There was 14% less TMJU (p<0.05) and 41% less TMNW (p<0.01) in Group I compared to Group II. The mean % of CPK-mb/CPK-t decreased in I and increased in II over the 3 Hrs of observation. Mean HR decreased (p<0.01) in I compared to II at 3 Hrs postocclusion. The sum of the mean T-wave amplitudes from the precordial electrode sites was less in I at 3 Hrs. It is felt that ST-261 had a protective effect on the myocardium during acute myocardial infarction.

scholarly journals Coronary flow and hemorrhagic complications after alteplase and streptokinase administration in patients with acute myocardial infarction

2009 ◽  
Vol 66 (3) ◽  
pp. 218-222
Author(s):  
Tomislav Kostic ◽  
Zoran Perisic ◽  
Dragan Milic ◽  
Svetlana Apostolovic ◽  
Sonja Salinger-Martinovic ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Major Bleeding ◽  
Coronary Flow ◽  
Coronary Intervention ◽  
Bleeding Complications ◽  
Group I ◽  
Number Of Patients ◽  
Significant Difference ◽  
St Elevation

Background/Aim. Up-to-date treatment of acute myocardial infarction (AIM) has been based on as early as possible establishment of circulation in ischemic myocardium whether by the use of fibrinolythic therapy and/or urgent coronary intervention which significantly changes the destiny of patients with AMI, but also increases the risk of bleeding. The aim of this study was to compare coronary flow and bleeding complications in patients with acute myocardial infarction with ST-elevation (STEMI) after administration of alteplase or streptokinase. Methods. The study included 254 patients with STEMI. The group I (n = 174) received streptokinase, and the group II (n = 80) received alteplase. We followed frequency of complications such as bleeding and hypotension in the investigated groups of patients, based on the TIMI classification of bleeding, as well as the transience of infarction artery in accordance with TIMI flow. Results. The patients with myocardial infarction after administration of alteplase had statistically significantly higher coronary flow (TIMI- 3), 72.5% as compared to the patients who received streptokinase, 39.2%. Hypotension as complication of fibrynolythic therapy administration occurred in a significantly higher percentage in the group of patients who received streptokinase. There was no statistically significant difference in the appearance of major bleeding in the groups of patients who received streptokinasis and alteplase (6.9% and 7.5%, respectively). Also, there was no difference in the appearance of minor and minimal bleeding among the investigated groups of patients. Conclusion. It was shown that alteplase in a higher number of patients provided TIMI-3 coronary flow as compared to streptokinese. In comparison with streptokinase, a combination of alteplase, enoxaparin and double antiplatelet therapy enabled earlier achievement of coronary flow through previously blocked coronary artery that was more complete (higher frequency of TIMI-3 flow). There were no statistically significant difference in frequency of bleeding, first of all major bleeding, between the groups treated by alteplase and streptokinase.

scholarly journals Coronary Angiographic Patency in Patients With Acute Myocardial Infarction With or Without Thrombolytic Therapy

1970 ◽  
Vol 3 (2) ◽  
pp. 136-142
Author(s):  
MM Rahman ◽  
SR Dey ◽  
M Shahabuddin ◽  
AK Kundu ◽  
Z Rahman ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Thrombolytic Therapy ◽  
Developed Countries ◽  
Late Presentation ◽  
Cross Sectional ◽  
Medical College ◽  
Group I ◽  
Infarct Related Artery ◽  
Streptokinase Therapy

Background: The myocardial infarction (MI) is a leading cause of morbidity and mortality in developed countries as well as in developing countries including Bangladesh. Streptokinase since its introduction has been shown to reduce mortality significantly. The outcome of MI treated with streptokinase can be evaluated either by CAG measurement of TIMI blood flow or by the measurement of ST segment resolution in 12 lead ECG. Methods: This cross sectional comparative study was conducted in the department of Cardiology in Sylhet M A G Osmani Medical college, to compare the patency between MI patients with or without streptokinase therapy, from Jan 2008 to Dec 2009. Considering enrollment criteria a total of 96 patients with acute MI were evaluated. All patients were categorized into two groups. Group-I (n=48), who received streptokinase and Group-II (n=48), who did not received the same(due to late presentation). CAG was done with in 7- 28 days of on set of pain. The patients admitting in coronary care unit with the diagnosis of STEMI were taken as the study subjects. Results: Adequate TIMI (thrombolysis in myocardial infarction) flow was higher who received streptokinase (85.4%) than those who did not receive the therapy (52.1%). Conclusion: This study indicates that streptokinase therapy is associated with rapid and sustained reperfusion of the infarct related artery in the treatment of acute myocardial infarction. Keywords: Myocardial infarction; Thrombolytic therapy; Streptokinase; Coronary angiographic patency. DOI: http://dx.doi.org/10.3329/cardio.v3i2.9182 Cardiovasc. J. 2011; 3(2): 136-142

Ratio of ST-Segment and myoglobin slopes to estimate myocardial salvage during thrombolytic therapy for acute myocardial infarction

1993 ◽  
Vol 71 (15) ◽  
pp. 1362-1365 ◽  
Author(s):  
Julie M. Baskin ◽  
Michelle L. Wilkins ◽  
E.Magnus Ohman ◽  
Peter Clemmensen ◽  
Peer Grande ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Thrombolytic Therapy ◽  
Myocardial Salvage ◽  
St Segment

scholarly journals The role of cytokines and cortisol in the non-thyroidal illness syndrome following acute myocardial infarction

2000 ◽  
pp. 236-242 ◽  
Author(s):  
H Karga ◽  
P Papaioannou ◽  
K Venetsanou ◽  
F Papandroulaki ◽  
L Karaloizos ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
First Episode ◽  
Necrosis Factor Alpha ◽  
Ventricular Ejection Fraction ◽  
Group I ◽  
Cortisol Levels ◽  
Group Ii

OBJECTIVE: A number of different hormone changes have been described during the acute myocardial infarction (AMI), including those of the non-thyroidal illness syndrome (NTIS). DESIGN AND METHODS: We assessed the alterations of serum thyroid hormones, cytokines and cortisol levels in 30 patients with a first episode of AMI 4, 24, 48h and 10 days (240h) after the onset of the chest pain and we investigated the possible relationship of these alterations with the severity of AMI. RESULTS: Fifteen patients had left ventricular ejection fraction (LVEF) </=50% (group I) and 15 patients had LVEF >50% (group II). A transient decrease of total tri-iodothyronine (T(3)), more prominent in group I (P<0.05, t-test) with a concomitant rise of reverse T(3 )(rT(3)) occurred at 24h. Total thyroxine (T(4)), free T(4) (FT(4)) and free T(4) index did not change significantly, but tended to be higher in group I patients, whereas TSH significantly increased in group II at 48h. Interleukin-6 (IL-6) increased significantly at 24h only in group I and declined thereafter (24 vs 240h, P<0.001) and this temporal change of IL-6 was associated with similar changes of creatine phosphokinase and creatine kinase isoenzyme MB (CK-MB). Tumor necrosis factor-alpha and IL-1beta remained low in both groups. Cortisol was higher at 4h and in 12 patients was above the normal values. Negative correlation was found between LVEF and IL-6 (P<0. 001), whereas T(3), T(4) or cortisol levels were not correlated with the LVEF. CONCLUSIONS: Our data indicate that NTIS, in association with increase of IL-6, occurs in the early post-infarction period. In the NTIS following AMI the high level of IL-6 is the best predictor, among several parameters, of the severity of AMI as assessed by the LVEF and the rise of CK-MB.

scholarly journals Prediction of Reperfusion and Infarct Related Artery Patency after Thrombolysis in Acute Anterior Myocardial Infarction by Degree of P Wave Dispersion on ECG

2018 ◽  
Vol 10 (2) ◽  
pp. 158-163
Author(s):  
Md Monir Hossain Khan ◽  
Md Afzalur Rahman ◽  
Abdullah Al Shafi Majumder ◽  
Khondker Shaheed Hussain ◽  
Md Toufiqur Rahman ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Thrombolytic Therapy ◽  
Wave Dispersion ◽  
P Wave ◽  
Anterior Myocardial Infarction ◽  
P Wave Dispersion ◽  
Timi Flow Grade ◽  
Group I ◽  
Before And After ◽  
Group Ii

Background: Early detection IRA patency following thrombolytic therapy is of great importance in terms of prognosis and identification of candidates for rescue percutaneous coronary intervention (PCI). P wave dispersion (PWD), a new parameter measured before and after thrombolytic therapy is supposed to predict successful reperfusion in patients with anterior acute myocardial infarction (AMI).Methods: 132 patients were selected and divided into two groups on the basis of ST Segment resolution (STR) after 120 minutes of thrombolysis. Group I: patients with STR >70%; Group II: patients with STR < 70%. P wave dispersion was measured in both groups before and after thrombolysis. All patients underwent coronary angiography (CAG). IRA was considered patent if TIMI flow grade was e”2.Results: It was observed that diabetes mellitus and dyslipidemia were significantly higher in group II patients (p=0.04 and p=0.03, respectively). PWD before thrombolysis (PWD0) and 90 minutes after thrombolysis (PWD90) in both groups were statistically insignificant (p=0.45 and p=0.19, respectively). The mean level of PWD120 was statistically significant (p=0.001). After multivariate regression analysis PWD120 was found to be the significant predictor of IRA patency (OR = 1.101; 95% CI = 1.012 – 1.240; p = 0.01).Conclusion: P wave dispersion in patients receiving thrombolytic therapy can be a predictor of successful reperfusion and patent IRA. PWD values, in combination with other reperfusion parameters, can contribute to the identification of rescue PCI candidates.Cardiovasc. j. 2018; 10(2): 158-163

scholarly journals MYOCARDIAL INFARCTION IN DIABETICS

2011 ◽  
Vol 18 (02) ◽  
pp. 269-274
Author(s):  
LIAQAT ALI ◽  
ABDUL REHMAN ABID ◽  
IMTIAZ AHMED ◽  
Nusrat Niaz ◽  
Tahira Abdul Rehman ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Circadian Rhythm ◽  
Symptom Onset ◽  
Group Iv ◽  
Inferior Wall ◽  
Morning Peak ◽  
Group I ◽  
Patients With Diabetes ◽  
Group Ii

Objective: To analyze the influence of diabetes mellitus on circadian rhythm affecting the onset of acute ST elevation myocardial infarction. Design: Observational study. Period: February to August 2010. Setting: Faisalabad Institute of Cardiology, Faisalabad. Materials and methods: Three hundred and seven consecutive patients who fulfilled the inclusion and exclusion criteria and presented with first MI were studied. All patients were divided into four groups according to the 6:00 hours interval of the day (Circadian rhythm). Group I comprised of patients presenting with onset of symptoms between 0-6 hours, Group II 6:01 to 12:00 hours, Group III 12:01 to 18:00 hours and Group IV 18:01 to 24:00 hours. Data was analyzed for variations within groups. Results: Two peaks of onset of symptoms were observed, first between 0-6 hours 144 (33.9%) patients and the second between 6:01 to 12:00 hours 87 (28.3%) and a non significant association was observed in time of onset of acute myocardial infarction P = 0.082. The trough was evening time 12:01 to 18:00 hours where only 63 (20.5%) patients had acute myocardial infarction. Mean age of study population was 56 ± 12.7 years. Mean age was similar in all the four groups P = 0.155. There were 228 (74.3%) males, 79 (25.5%) females. The circadian morning peak of MI symptom onset was attenuated in patients with diabetes as Group IV consisted of higher number 24 (37.5%) of diabetics followed by group I 23 (34.7%). Overall group II had the maximum number of hypertensive patients 41 (47.1%) as compared to other groups. Obesity was observed in 55 (18%) with similar number of patients in all groups P = 0.492. Majority of patients 117 (38.1%) presented between 4-8 hours after the onset of symptoms. Overall 170 (55.4%) patients had anterior wall myocardial infarction followed by inferior wall myocardial infarction in 82 (26.7%) patients. Conclusions: Our study demonstrates that the circadian morning peak of MI symptom onset was attenuated in patients with diabetes, suggesting a role of autonomic dysfunction. Inconsistency in observation of such an effect in patients with diabetes in the past may well have been due to differences in the duration of diabetes.

scholarly journals ACUTE MYOCARDIAL INFARCTION

2006 ◽  
Vol 13 (02) ◽  
pp. 178-185
Author(s):  
ABDUL REHMAN ABID ◽  
M. Shahid Naveed ◽  
LIAQAT ALI ◽  
Siraj Munir Ahmed Tarin ◽  
M. TAHIR MOHYUDDIN ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hospital Mortality ◽  
Hospital Stay ◽  
Group Iv ◽  
Age Group ◽  
Group Iii ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

Women with acute myocardial infarction have higher in-hospital mortalitythan men mainly due to greater age on presentation. Objective: To evaluate the age specific sex difference in inhospitalmortality of acute myocardial infarction. Design: Descriptive study. Place and duration: Coronary Care Unitand cardiology ward of Nishtar Hospital Multan from 15 of th September 2002 till 30th of April 2003. Material & Methods:Four hundred and fifty patients of acute myocardial infarction who fulfilled our inclusion criteria were studied while theywere admitted to the hospital. Patients were divided into four groups according to age and sex i.e. Group I (male <45years), Group II (male $45 years), Group III (female <45 years) and Group IV (female $45 years). In-hospital mortalitywas compared between different age groups by Chi-square test. Results: The total in-hospital mortality was76(16.9%).In Group III none of the patients expired. In Group I in-hospital mortality was 6(7.1%) patients followed byGroup II 50(18.3%) patients and Group IV 20(23.3%) patients p<0.019. In-hospital mortality was greater in Group IVthan in any other group. Group IV patients were more frequently diabetic and hypertensive than patients in any othergroup. Group IV patients presented late to the hospital. There was no significant difference in site of myocardialinfarction in different groups. Higher Killip class was observed in Group II and IV p<0.05. Streptokinase injection wasgiven less frequently in Group IV than in any other group p <0.012. Only 34(39.5%) patients in Group IV had nocomplication during hospital stay while more patients in other groups had uneventful hospital stay p<0.001.Conclusion: Female sex is associated with higher in-hospital mortality in older age group as compared to the malepatients of same age group.

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