ABSTRACT
Since July 2002 we have been conducting a study of efficacy of prehospital thrombolytic therapy combined with subsequent endovascular procedures in the treatment of patients with acute myocardial infarction. Fifty nine patients received prehospital fibrinolysis with tissue-type plasminogen activator (TPA, n=28) or streptokinase (n=31) within 6 hours after onset of symptoms. TPA infusion compared with that of streptokinase was associated with smaller ischemic myocardial damage and lower frequency of side effects (3.6 and 38.7%, respectively). Angioplasty or stenting of infarct related arteries were carried out in 47 of these patients. The group of patients subjected to endovascular interventions was characterized by a low rate of in-hospital cardiac events and zero mortality.
Subject(s)
Angioplasty, Balloon, Coronary , Emergency Medical Services/methods , Fibrinolytic Agents/therapeutic use , Myocardial Infarction/therapy , Thrombolytic Therapy , Coronary Angiography , Electrocardiography , Female , Follow-Up Studies , Humans , Male , Middle Aged , Myocardial Infarction/diagnostic imaging , Myocardial Infarction/physiopathology , Streptokinase/therapeutic use , Tissue Plasminogen Activator/therapeutic use , Treatment OutcomeABSTRACT
The problem of stent thrombosis in patients with myocardial infarction is reviewed with consideration of possible mechanisms and causes of in-stent thrombus formation during first 30 days after the procedure. Roles of the patient factor, factor of the stented vessel, stent in self, stent deployment technique, and management after stenting are discussed.
