A Comparison of Immediate Coronary Angioplasty with Intravenous Streptokinase in Acute Myocardial Infarction

• Published in: The New England journal of medicine Vol. 328; no. 10; pp. 680 - 684
• Main Authors: Zijlstra, Felix, de Boer, Menko Jan, Hoorntje, Jan, Reiffers, Stoffer, Reiber, Johan, Suryapranata, Harry
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 11.03.1993
• Subjects: Angina; Angina pectoris; Angiography; Angioplasty; Angioplasty, Balloon, Coronary; Arteries; Biological and medical sciences; Blood clots; Blood. Blood coagulation. Reticuloendothelial system; Cardiology; Cardiovascular disease; Coronary Angiography; Coronary vessels; Drug dosages; Electrocardiography; Female; Heart; Heart attacks; Humans; Injections, Intravenous; Intravenous administration; Ischemia; Laboratories; Male; Medical sciences; Middle Aged; Myocardial infarction; Myocardial Infarction - physiopathology; Myocardial Infarction - therapy; Myocardial ischemia; Nuclear medicine; Pain; Pharmacology. Drug treatments; Prospective Studies; Recurrence; Reperfusion; Stenosis; Streptokinase; Streptokinase - administration & dosage; Stroke Volume; Thrombolysis; Thrombolytic Therapy; Time Factors; Treatment Outcome; Veins & arteries; Ventricle; Human; Intravenous administration; Infarct; Acute; Instrumentation therapy; Cardiovascular disease; Instrumental dilatation; Chemotherapy; Streptokinase; Treatment; Heart disease; Myocardium; Comparative study; Fibrinolytic
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJM199303113281002

In 1980 DeWood et al. 1 showed that acute transmural myocardial infarction is usually associated with total coronary occlusion due to an intraluminal coronary thrombus superimposed on an atherosclerotic lesion. Over the past decade the efficacy of thrombolytic therapy and coronary angioplasty in restoring patency to the infarct-related coronary artery has been studied extensively 2 – 9 . Although “rescue” angioplasty may be advantageous in infarct-related arteries that fail to reperfuse after thrombolytic therapy, 10 in general there is no additional benefit of routine angioplasty after thrombolytic therapy 7 , 8 . The results of recently published randomized trials indicate that the combination of streptokinase, aspirin, . . .