Infarct size, estimated by electrocardiographic changes (the QRS Scoring System, developed by Wagner et al, Circulation 65,342, 1982) and enzymatic analysis (creatinine kinase, CK) was studied in 45 patients with no history of previous infarcts. 25 received an intravenous dose of DDAVP (0.3 ug/kg) and 20 received a placebo solution (saline). The time between the onset of symptoms and DDVAP administration was less than 12 hours. The results showed no significant differences between the two groups in maximal or acumulative activity of creatinine kinase (CKr) or the QRS score peak. However, in patients with a mean evolution time of less than 1 hour, the CK peak was significantly lower in the DDAVP group than in the placebo group (p<0.05). Furthermore the percent of maximal increase in the QRS score was lower in the DDAVP group than in the patients receiving the placebo (p=0.1). On admission, the fibrinolytic activity of euglobulin fractions (measured by fibrin plates) was higher in the patients in both groups than in a group of healthy subjects (n=40). Also, DDAVP significantly increased fibrinolyric activity whereas no changes were found in patients receiving the placebo. The mean CKr value was lower in patients with an increase in fibrinolysis than in those who showed no changes in it. Finally, in the DDAVP group the QRS score peak was strongly dependent on the initial QRS score and, regarding this, our results suggest that small infarcts on admission may represent a potential indication for DDAVP therapy.
Troponine I versus Creatinine Kinase-MB as Predictor Markers of the Severity and Outcomes in Acute Theophylline Toxicity
