Infarto agudo del miocardio: eficacia trombolítica de 500.000 UI de estreptokinasa asociada a heparina / Acute myocardial infarction: thrombolytic efficacy of 500.000 UI of streptokinase combined with heparin

RESUMO

Most reports concerning the use of streptokinase (SK) for thrombolysis in myocardial infarction (MI) have employed doses ovber 1 000 000 units. We evaluated the efficace of a dose of 500 000U in 40 patients with acute MI who received full heparin dose before, during and after SK. Thrombolytic effect, as measured by the protamine neutralized thrombin time was shown to be strong in 60% of cases, moderate in 17% and weak in 22%, and this was not modified by larger SK doses. A patent culprit artery ws demonstrated at coronary arteriography performed 3 days after SK in 90% of patients. Only one instance of severe bleeding was observed. Thus, a reduzed SK dose in association to heparine provides adequate lytic efect and artery patency rate in patients with MI