Resolution of ST-segment elevation after streptokinase therapy in anterior versus inferior wall myocardial infarction.
Clin Cardiol
; 23(7): 490-4, 2000 Jul.
Article
em En
| MEDLINE
| ID: mdl-10894436
ABSTRACT
BACKGROUND:
Resolution of ST-segment elevation is the best bedside predictor of myocardial reperfusion.HYPOTHESIS:
This study was conducted to examine the resolution of ST-segment elevation after streptokinase therapy in anterior versus inferior acute myocardial infarction (MI) and to corroborate it with echocardiographic and coronary angiographic data.METHODS:
The study population consisted of 70 patients, 35 each in the anterior and inferior MI groups. The electrocardiograms (ECGs) were recorded before, on completion of, and on Days 1 and 2 post streptokinase therapy. The resolution of ST segment determined from post-streptokinase ECGs was compared between the two groups and correlated with echocardiographic and coronary angiographic data.RESULTS:
On completion of and on Day 1 post streptokinase therapy, ST-segment resolution in both groups was not significantly different. On Day 2 post streptokinase therapy, resolution of the ST segment per lead was significantly lower in anterior than that in inferior MI (61 +/- 21% anterior vs. 77 +/- 21% inferior, p 0.003). The number of patients with akinesis of infarct-related ventricular wall was significantly higher (17 anterior vs. 7 inferior, p 0.02), and left ventricular ejection fraction was significantly lower in anterior MI (39 +/- 7% anterior vs. 48 +/- 8% inferior, p < 0.01). There was no significant difference in coronary angiographic data. One patient in each group demonstrated normal coronary arteries.CONCLUSIONS:
The resolution of ST-segment elevation on the completion of and on Day 1 post streptokinase therapy was comparable between anterior and inferior MI. The significantly less frequent resolution of ST-segment elevation in anterior MI on Day 2 post streptokinase could be due to more akinesis, larger infarct size, and worse systolic function rather than due to failure to open the infarct-related vessel.
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Base de dados:
MEDLINE
Assunto principal:
Estreptoquinase
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Ativadores de Plasminogênio
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Recuperação de Função Fisiológica
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Eletrocardiografia
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Infarto do Miocárdio
Idioma:
En
Ano de publicação:
2000
Tipo de documento:
Article