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Factors influencing probability of reperfusion with intracoronary ostial infusion of thrombolytic agent in patients with acute myocardial infarction.
- Source :
-
Circulation [Circulation] 1985 Jan; Vol. 71 (1), pp. 124-8. - Publication Year :
- 1985
-
Abstract
- A multivariate logistic regression equation was used to evaluate variables related to successful intracoronary thrombolytic therapy. One hundred seventeen patients with a totally occluded infarct-related artery were randomly given ostial infusions of urokinase or streptokinase in a blinded study. The opening rate was 57%. The agent used and time from onset of symptoms to beginning of treatment did not significantly influence opening rate (p greater than .25). The site of occlusion was a strong predictor of opening rate (p = .0004). The anterior descending coronary artery was successfully opened more frequently than the left circumflex or right coronary artery (p = .012). Presence of collaterals adversely affected the recanalization rate in all groups (p = .0004). These variables had an additive effect on the probability of opening. Patients with proximal anterior descending occlusion and no collaterals had a 90% recanalization rate, while those with distal occlusions in vessels other than the anterior descending and with collaterals had only a 24% chance for reperfusion. Thus location of occlusion and presence or absence of collaterals may strongly influence opening rates.
- Subjects :
- Adult
Aged
Collateral Circulation
Coronary Vessels
Female
Fibrinolytic Agents therapeutic use
Humans
Infusions, Intra-Arterial
Male
Middle Aged
Myocardial Infarction physiopathology
Probability
Regression Analysis
Streptokinase administration & dosage
Time Factors
Urokinase-Type Plasminogen Activator administration & dosage
Coronary Circulation drug effects
Fibrinolytic Agents administration & dosage
Myocardial Infarction drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 0009-7322
- Volume :
- 71
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Circulation
- Publication Type :
- Academic Journal
- Accession number :
- 3964713
- Full Text :
- https://doi.org/10.1161/01.cir.71.1.124