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Coronary angioplasty immediately after thrombolysis in 115 consecutive patients with acute myocardial infarction. 1988

H Suryapranata, and P W Serruys, and P J de Feyter, and M van den Brand, and K Beatt, and R van Domburg, and P P Kint, and P G Hugenholtz
Thoraxcenter, Erasmus University, Rotterdam, The Netherlands.

Between September 1981 and May 1986, coronary angioplasty immediately after intracoronary thrombolysis was attempted in 115 patients with acute myocardial infarction. The present study describes our experience with this combined procedure. Primary success was achieved in 102 patients (89%). Before discharge, 79 of these patients agreed to be restudied angiographically. The infarct-related vessel was still patent in 71 patients (patency rate of 90%). Sequential left ventricular angiograms of quality sufficient to allow automated analysis were obtained in 58 patients. Global ejection fraction improved significantly from 52 +/- 10% to 55 +/- 9% (p = 0.01) from the acute to the chronic stage. In patients with anterior infarction, the increase in global ejection fraction was primarily the result of significant improvement of the regional myocardial function of the infarct zone. No significant changes in global and regional myocardial function could be seen in patients with inferior infarction. However, when patients in whom the infarct-related vessel was reoccluded at follow-up angiography are excluded from analysis, the global and regional myocardial function did improve significantly irrespective of the location of the infarct. Median clinical follow-up of 20 months (range 4 to 50) resulted in an overall mortality rate of 4%. Preservation of global and regional left ventricular function with a low mortality rate suggests that immediate coronary angioplasty after thrombolysis can be safely used to provide reperfusion in the setting of acute myocardial infarction and that this combined procedure may be the optimal mode of therapy. Further randomized studies are warranted to precisely define the role of coronary angioplasty in acute myocardial infarction.

UI MeSH Term Description Entries
D007091 Image Processing, Computer-Assisted A technique of inputting two-dimensional or three-dimensional images into a computer and then enhancing or analyzing the imagery into a form that is more useful to the human observer. Biomedical Image Processing,Computer-Assisted Image Processing,Digital Image Processing,Image Analysis, Computer-Assisted,Image Reconstruction,Medical Image Processing,Analysis, Computer-Assisted Image,Computer-Assisted Image Analysis,Computer Assisted Image Analysis,Computer Assisted Image Processing,Computer-Assisted Image Analyses,Image Analyses, Computer-Assisted,Image Analysis, Computer Assisted,Image Processing, Biomedical,Image Processing, Computer Assisted,Image Processing, Digital,Image Processing, Medical,Image Processings, Medical,Image Reconstructions,Medical Image Processings,Processing, Biomedical Image,Processing, Digital Image,Processing, Medical Image,Processings, Digital Image,Processings, Medical Image,Reconstruction, Image,Reconstructions, Image
D007261 Infusions, Intra-Arterial Regional infusion of drugs via an arterial catheter. Often a pump is used to impel the drug through the catheter. Used in therapy of cancer, upper gastrointestinal hemorrhage, infection, and peripheral vascular disease. Infusions, Regional Arterial,Infusions, Intra Arterial,Infusions, Intraarterial,Arterial Infusion, Intra,Arterial Infusion, Regional,Arterial Infusions, Intra,Arterial Infusions, Regional,Infusion, Intra Arterial,Infusion, Intra-Arterial,Infusion, Intraarterial,Infusion, Regional Arterial,Intra Arterial Infusion,Intra Arterial Infusions,Intra-Arterial Infusion,Intra-Arterial Infusions,Intraarterial Infusion,Intraarterial Infusions,Regional Arterial Infusion,Regional Arterial Infusions
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009203 Myocardial Infarction NECROSIS of the MYOCARDIUM caused by an obstruction of the blood supply to the heart (CORONARY CIRCULATION). Cardiovascular Stroke,Heart Attack,Myocardial Infarct,Cardiovascular Strokes,Heart Attacks,Infarct, Myocardial,Infarction, Myocardial,Infarctions, Myocardial,Infarcts, Myocardial,Myocardial Infarctions,Myocardial Infarcts,Stroke, Cardiovascular,Strokes, Cardiovascular
D003131 Combined Modality Therapy The treatment of a disease or condition by several different means simultaneously or sequentially. Chemoimmunotherapy, RADIOIMMUNOTHERAPY, chemoradiotherapy, cryochemotherapy, and SALVAGE THERAPY are seen most frequently, but their combinations with each other and surgery are also used. Multimodal Treatment,Therapy, Combined Modality,Combined Modality Therapies,Modality Therapies, Combined,Modality Therapy, Combined,Multimodal Treatments,Therapies, Combined Modality,Treatment, Multimodal,Treatments, Multimodal
D005260 Female Females
D005343 Fibrinolytic Agents Fibrinolysin or agents that convert plasminogen to FIBRINOLYSIN. Antithrombic Drug,Antithrombotic Agent,Antithrombotic Agents,Fibrinolytic Agent,Fibrinolytic Drug,Thrombolytic Agent,Thrombolytic Agents,Thrombolytic Drug,Antithrombic Drugs,Fibrinolytic Drugs,Thrombolytic Drugs,Agent, Antithrombotic,Agent, Fibrinolytic,Agent, Thrombolytic,Agents, Antithrombotic,Drug, Antithrombic,Drug, Fibrinolytic,Drug, Thrombolytic,Drugs, Antithrombic
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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