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Once the experience of GISSI I was concluded, the as yet unresolved problem of the choice of one fibrinolytic agent in preference to others emerged. In the present study, the authors used echocardiography in order to compare streptokinase with r-TPA in order to limit myocardial damage in acute myocardial infarction in 33 patients, average age 64.6 years. No statistically significant difference between the two drugs was observed as far as left ventricular contractility and extent of the infarcted region was concerned. This was in accordance with the findings of the Italian PAIMS study.

Hyperkinetic ventricular arrhythmia being the main cause of electrical destabilization and hence fatal tachy-arrhythmias, we have studied, by Holter test, the prevalence of these arrhythmias in ambulatory non-professional athletes and compared it with a homogeneous group of sedentary subjects in order to evaluate if sports, even if not in athletic competitions, represent a potential risk for sudden death. The results show the prevalence of hyperkinetic ventricular arrhythmias to be similar in the two groups and not related to sports.

The authors evaluate old patients of both sexes with acute myocardial infarction. They study coronary risk factors, symptomatology onset, infarction site, complications and survival in Intensive Care Unit. The elderly women show significant features in comparison with the male as the particular predictive value of diabetes and hypertension and the greater atypia of clinical findings. The unforeseeable development of coronary artery disease in the female is confirmed also in the elderly.

The potassium-retaining action was evaluated in its kaliemic reflexes, in two diuretic associations composed respectively of hydrochlorothiazide + spironolactone and hydrochlorothiazide + amiloride. The potassium intraerythrocytic levels were also determined as well as the natriuresis, the natremia and the daily diuresis. Researches carried out on a group of patients affected by congestive heart failure showed that, the diuretic efficacy being equal, the association of hydrochlorothiazide + spironolactone does not significantly interfere, at the various posologic levels, with the potassium balance. On the contrary, in this regard, the associaiton of amiloride + hydrochlorothiazide appeared to be less manageable because therapeutic dosages showed a tendency to hyperdaliemia.

Acute myocardial infarction in the elderly shows epidemiological and clinical features different from those observed in the same pathology in the young-adult subject. In this study, the authors compare literature data with their experience of 309 subjects aged greater than or equal to 65 years vs. 268 controls. All these patients were hospitalized for acute myocardial infarction in an Intensive Care Unit. Risk factors, symptomatology at onset, lesion site and survival in the Intensive Care Unit were examined. Our study establishes that cardiologists need special diagnostic accuracy to evaluate coronary artery disease in old patients.