Residual coronary stenosis after thrombolysis with rt-PA or streptokinase: acute results and 3 weeks follow-up

• Published in: European heart journal 1987-11, Vol.8 (11), p.1182-1188
• Main Authors: SCHMIDT, W. G., UEBIS, R., ESSEN, R. V., EFFERT, S., ERBEL, R., MEYER, J., RURSCH, W., SCHARTL, M., SCHMUTZLER, H.
• Format: Article
• Language: English
• Subjects: Cineangiography; Clinical Trials as Topic; Coronary Angiography; Coronary Disease - drug therapy; coronary stenosis; Follow-Up Studies; Humans; Middle Aged; Myocardial infarction; plasminogen activator; Radiographic Image Interpretation, Computer-Assisted; Random Allocation; Recombinant Proteins - therapeutic use; Recurrence; Streptokinase - therapeutic use; thrombolysis; Tissue Plasminogen Activator - therapeutic use; Vascular Patency - drug effects
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1093/oxfordjournals.eurheartj.a062190

Ninety-one patients with acute myocardial infarction were assigned to intravenous treatment with streptokinase or rt-PA as part of the randomized trial carried out by the European Study Group for Recombinant Tissue-Type Plasminogen Activator (rt-PA). A patent coronary artery was found in 37 of 45 (82%) patients treated with rt-PA and in 27 of 46 (59%) patients treated with streptokinase 75–90 minutes after start of infusion. Patients were subsequently anticoagulated with heparin or dicoumarol up to a repeat angiography 3 weeks after the infarction. Of the 64 patients with successful reperfusion, 3 died and 3 suffered reocclusion of the vessel. Quantitative analysis of the coronary stenosis both immediately after thrombolvsis and at 3 weeks follow-up was possible in 33 cases. Residual stenosis (percentage narrowing of diameter) decreased from 74± 14% to 56± 17% P