scholarly journals Clinical Impacts of ST- Segment Non-Resolution after Thrombolysis for Myocardial Infarction

2019 ◽  
Vol 15 (1) ◽  
pp. 3-7
Author(s):  
Syed Aminul Islam ◽  
Md Faruque ◽  
Fazlur Rahman ◽  
Harisul Hoque ◽  
Nilufar Fatema
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Thrombolytic Therapy ◽  
Early Mortality ◽  
P Value ◽  
Clinical Markers ◽  
Average Hospital ◽  
St Segment ◽  
Clinical Consequences ◽  
Streptokinase Therapy

Streptokinase therapy for acute myocardial infarction reduces early mortality and improves outcomes. Failure of reperfusion after streptokinase therapy for acute myocardial infarction is common and indicates a poor prognosis. We investigated the clinical consequences of non-resolution of the ST segment after thrombolytic therapy for acute ST-elevation myocardial infarction, in 80 consecutive patients admitted to a coronary care unit. Failed thrombolysis was defined as <50% ST-segment resolution at 90 minutes after the start of thrombolytic treatment. Outcomes were measured in terms of in hospital adverse events and mortality at 6 weeks. Thrombolysis was successful, in terms of ST-segment resolution, in 59 patients (73.75%). After adjustment for other factors, ST resolution was the only independent predictor of an uncomplicated recovery in hospital. ST-segment resolution is a useful marker of successful thrombolysis and relates to clinical outcome. Average hospital stay was 2 days greater in non resolved ST-segment group than in ST-segment resolved group. At 6 weeks overall early mortality was much lower in the ST segment resolution group (1.7% versus 57.1% with P value of <0.001). So, non resolution of ST-segment in electrocardiogram following thrombolytic therapy in acute STEMI has paramount importance. If assessed routinely it might assist, along with other clinical markers, in the identification of high risk patients. University Heart Journal Vol. 15, No. 1, Jan 2019; 3-7

Early assessment of outcome by ST-segment analysis after thrombolytic therapy in acute myocardial infarction

1994 ◽  
Vol 128 (5) ◽  
pp. 851-857 ◽  
Author(s):  
Rüdiger Dissmann ◽  
Rolf Schröder ◽  
Ulrike Busse ◽  
Mathias Appel ◽  
Thomas Brüggemann ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Thrombolytic Therapy ◽  
Early Assessment ◽  
St Segment

The Critical Care Nurse’s Role in the Noninvasive Assessment of Myocardial Reperfusion

1990 ◽  
Vol 1 (1) ◽  
pp. 110-118
Author(s):  
Marlene R. Kleven
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Thrombolytic Therapy ◽  
Standard Of Care ◽  
Reperfusion Therapy ◽  
Myocardial Reperfusion ◽  
Direct Visualization ◽  
Review Of The Literature ◽  
St Segment ◽  
Noninvasive Assessment

Thrombolytic therapy is rapidly becoming the standard of care for the treatment of acute myocardial infarction (AMI). The goal of thrombolytic therapy is clot dissolution in the infarct artery that results in re-establishing blood flow to affected ischemic myocardium. Confirmation of the occurrence of reperfusion can only be established by direct visualization of the coronary artery. Clinical reperfusion markers (dysrhythmias, chest pain relief, ST segment normalization, CK peak values) have also been associated with myocardial reperfusion. These markers are noninvasive and are routinely relied on in the clinical setting. However, a review of the literature reveals that the noninvasive reperfusion markers individually lack reliability in successfully predicting reperfusion status. Because of the importance of establishing the success of reperfusion therapy early in the treatment of AMI, it is critical that the nurse at the bedside be aware of the criteria that can be established to improve the reliability of the reperfusion markers and their limitations.

Resolution of ST-segment elevation in acute myocardial infarction — Early prognostic significance after thrombolytic therapy

Herz ◽  
1999 ◽  
Vol 24 (6) ◽  
pp. 440-447 ◽  
Author(s):  
Joerg Carlsson ◽  
Uwe Kamp ◽  
Dirk Härtel ◽  
Johannes Brockmeier ◽  
Rainer Meierhenrich ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Thrombolytic Therapy ◽  
Prognostic Significance ◽  
St Segment Elevation ◽  
St Segment

scholarly journals Early ST-segment elevation acute myocardial infarction after thrombolytic therapy for acute ischemic stroke

Medicine ◽  
2018 ◽  
Vol 97 (50) ◽  
pp. e13347 ◽  
Author(s):  
Maria Mirabela Manea ◽  
Dorin Dragoş ◽  
Emanuel Stoica ◽  
Adrian Bucşa ◽  
Ioana Marinică ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Ischemic Stroke ◽  
Thrombolytic Therapy ◽  
Acute Ischemic Stroke ◽  
St Segment Elevation ◽  
St Segment ◽  
Elevation Acute Myocardial Infarction

scholarly journals Что мы знаем сегодня об отечественном тромболитическом препарате рекомбинантная проурокиназа (пуролаза)

2019 ◽  
Author(s):  
S.G. Milenkina ◽  
E.P. Delver ◽  
A.A. Belogurov ◽  
R.SH. Bibilashvilli ◽  
E.V. Arzamastsev ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Thrombolytic Therapy ◽  
Coronary Intervention ◽  
Technical Aspects ◽  
St Segment Elevation ◽  
Thrombolytic Drug ◽  
St Segment ◽  
Percutaneous Coronary ◽  
Current Guidelines

В обзоре представлены основные данные о создании отечественного тромболитического препарата III поколения рекомбинантной проурокиназы и применении ее у пациентов с острым инфарктом миокарда с подъемом сегмента ST (ИМпST). Современные рекомендации отдают предпочтение первичному чрескожному коронарному вмешательству (ЧКВ). Однако ряд логистических и технических особенностей нередко делает проведение ЧКВ в рекомендованные сроки невозможным, и медикаментозная реперфузия остается методом выбора. Своевременная тромболитическая терапия (ТЛТ) позволяет уменьшить время до начала реперфузии и улучшить прогноз больного. Накоплен значительный опыт догоспитального и госпитального применения рекомбинантной проурокиназы. В статье рассмотрены результаты основных исследований эффективности и безопасности, а также особенностей применения рекомбинантной проурокиназы, в том числе при использовании фармакоинвазивного подхода к лечению ИМпST. Ключевые слова: острый инфаркт миокарда с подъемом сегмента ST, тромболитическая терапия, пуролаза, рекомбинантная проурокиназа, фармакоинвазивный подход.The review presents the main data on the development of thrombolytic drug of the III generation of recombinant prourokinase produced in Russia and its administration in patients with acute myocardial infarction with ST segment elevation (STEMI). Current guidelines prefer primary percutaneous coronary intervention (PCI). However, a number of logistical and technical aspects often make it impossible to carry out PCI within the recommended time, and drug reperfusion remains the method of choice. Well-timed thrombolytic therapy (TLT) can reduce the time before reperfusion and improve the patients prognosis. Significant experience in pre-hospital and hospital is adepted at use of recombinant prourokinase. The article considers the results of the main studies of the effectiveness and safety, as well as the aspects of the use of recombinant prourokinase, including the use of pharmacoinvasive approach to the treatment of STEMI. Key words: acute myocardial infarction with ST-segment elevation, thrombolytic therapy, Purolase, pharmacoinvasive approach.

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

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