[The frequency of early coronary reperfusion assessed by electrocardiographic criteria in relation to the timing of thrombolytic therapy in acute myocardial infarct]. / Frequenza della riperfusione coronarica precoce valutata con criteri elettrocardiografici in rapporto al tempo del trattamento trombolitico nell'infarto miocardico acuto.

ABSTRACT

This study was aimed at assessing coronary reperfusion in patients with acute myocardial infarction (AMI) undergoing systemic thrombolysis with SK and rtPA. The occurrence of reperfusion was related to the time of treatment. The evaluation of reperfusion was performed by monitoring ST segment changes. 56 patients with AMI were studied. 22 out of these (39.2%) showed a significant decrease (greater than 50%) in ST segment sum (sigma ST) at 100 minutes from the beginning of the treatment. Analysis of the relationship between reperfusion and elapsed time between the onset of symptoms and the treatment, reveals that the reperfusion is less frequent (p less than 0.05) in patients treated at 180 minutes or later. The standard electrocardiogram appears as the most useful method to evaluate indirectly coronary reperfusion in acute myocardial infarction. A further refinement of this method is desirable to recommend its widespread clinical use. The assessment of reperfusion by means of ECG in large series of patients will permit the evaluation of the benefits of reperfusion, in terms of survival, complications and incidence of ventricular dysfunction.