Importance of early and complete reperfusion to achieve myocardial salvage after thrombolysis in acute myocardial infarction
The importance of the timing and completeness of coronary artery reperfusion for limitation of acute myocardial infarction (AMI) size after intravenous thrombolytic therapy was studied in 39 patients. All had electrocardiographic epicardial injury and acute coronary angiography performed
Gespeichert in:
| Veröffentlicht in: | The American journal of cardiology 1992-12, Vol.70 (18), p.1391-1396 |
|---|---|
| Hauptverfasser: | , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1396 |
|---|---|
| container_issue | 18 |
| container_start_page | 1391 |
| container_title | The American journal of cardiology |
| container_volume | 70 |
| creator | Clemmensen, Peter Ohman, E.Magnus Sevilla, Dorina C. Wagner, Nancy B. Quigley, Peter S. Grande, Peer Wagner, Galen S. |
| description | The importance of the timing and completeness of coronary artery reperfusion for limitation of acute myocardial infarction (AMI) size after intravenous thrombolytic therapy was studied in 39 patients. All had electrocardiographic epicardial injury and acute coronary angiography performed |
| doi_str_mv | 10.1016/0002-9149(92)90287-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_73356543</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>0002914992902879</els_id><sourcerecordid>73356543</sourcerecordid><originalsourceid>FETCH-LOGICAL-c386t-2f7cec3d134daf0a5396f6dc88e26c93ee29512ee693869d6e4a986dec22d0cf3</originalsourceid><addsrcrecordid>eNp9kU2LFDEQhoMo67j6DxRykEUPvearM52LIIsfCwt70XOoTSpupLvTJumBAX_8ZphhxYunItTzvoSnCHnN2SVnXH9gjInOcGXeGfHeMDFsO_OEbPiwNR03XD4lm0fkOXlRyq_25LzXZ-SMKyU00xvy53paUq4wO6QpUIQ87inMnro0LSNWpBkXzGEtMc20JgruPuIO6bRPDrKPMNIC4w5-IoVQMdN6n9N0l8Z9iYXGuQXW-g8e5wDZ1db3kjwLMBZ8dZrn5MeXz9-vvnU3t1-vrz7ddE4OunYibB066blUHgKDXhodtHfDgEI7IxGF6blA1KbxxmtUYAbt0QnhmQvynFwce5ecfq9Yqp1icTiOMGNai91K2eteyQaqI-hyKiVjsEuOE-S95cwepNuDUXswak2bB-nWtNibU_96N6H_Gzpabvu3pz0UB2PITXcsj5hSmqtBNOzjEcPmYhcx2-Iitsv4mNFV61P8_z8eAAvIoNU</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>73356543</pqid></control><display><type>article</type><title>Importance of early and complete reperfusion to achieve myocardial salvage after thrombolysis in acute myocardial infarction</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><creator>Clemmensen, Peter ; Ohman, E.Magnus ; Sevilla, Dorina C. ; Wagner, Nancy B. ; Quigley, Peter S. ; Grande, Peer ; Wagner, Galen S.</creator><creatorcontrib>Clemmensen, Peter ; Ohman, E.Magnus ; Sevilla, Dorina C. ; Wagner, Nancy B. ; Quigley, Peter S. ; Grande, Peer ; Wagner, Galen S.</creatorcontrib><description>The importance of the timing and completeness of coronary artery reperfusion for limitation of acute myocardial infarction (AMI) size after intravenous thrombolytic therapy was studied in 39 patients. All had electrocardiographic epicardial injury and acute coronary angiography performed <8 hours after symptom onset. Acutely jeopardized myocardium was estimated at baseline, and before and after angiography by quantitative ST-segment analysis. The AMI size was estimated on the final electrocardiogram by the Selvester QRS score. Left ventricular ejection fraction was measured at the time of acute angiography and before discharge in 31 of these patients. In the 21 patients with normal flow (Thrombolysis in Myocardial Infarction [TIMI] trial grade 3) in the infarct-related artery, the amount of jeopardized myocardium decreased from baseline to that before and after angiography (17 to 11 and 11%, respectively; p <0.00005), and the median final AMI size was reduced (17 to 9%; p = 0.0004). In 6 patients with suboptimal flow (TIMI grade 2), the median amount of jeopardized myocardium decreased slightly from baseline to that before to after angiography (15 to 12%); however, the median final AMI size was not reduced (17%). In 12 patients with no reperfusion (TIMI 0 to 1) flow, the median amount of jeopardized myocardium remained unchanged from baseline to that before angiography (21%), and the final AMI size was not significantly reduced. There was a significant inverse correlation between the change in global left ventricular function and the difference between electrocardiographic estimated jeopardized and final AMI size (r
s = −0.53; p = 0.008). The final AMI size in the TIMI 3 group was 47% smaller than in the combined TIMI 0 to 1 and 2 groups (p = 0.057). These findings suggest that only early and complete AMI reperfusion will result in myocardial salvage.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/0002-9149(92)90287-9</identifier><identifier>PMID: 1442606</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Aged ; Biological and medical sciences ; Cardiology. Vascular system ; Coronary Angiography ; Coronary heart disease ; Coronary Vessels - pathology ; Electrocardiography ; Gated Blood-Pool Imaging ; Heart ; Humans ; Medical sciences ; Middle Aged ; Myocardial Infarction - drug therapy ; Myocardial Infarction - pathology ; Myocardial Infarction - physiopathology ; Myocardial Reperfusion ; Myocardium - pathology ; Streptokinase - therapeutic use ; Stroke Volume - physiology ; Thrombolytic Therapy ; Tissue Plasminogen Activator - therapeutic use ; Urokinase-Type Plasminogen Activator - therapeutic use ; Vascular Patency ; Ventricular Function, Left - physiology</subject><ispartof>The American journal of cardiology, 1992-12, Vol.70 (18), p.1391-1396</ispartof><rights>1992</rights><rights>1993 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c386t-2f7cec3d134daf0a5396f6dc88e26c93ee29512ee693869d6e4a986dec22d0cf3</citedby><cites>FETCH-LOGICAL-c386t-2f7cec3d134daf0a5396f6dc88e26c93ee29512ee693869d6e4a986dec22d0cf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/0002-9149(92)90287-9$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=4461482$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/1442606$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Clemmensen, Peter</creatorcontrib><creatorcontrib>Ohman, E.Magnus</creatorcontrib><creatorcontrib>Sevilla, Dorina C.</creatorcontrib><creatorcontrib>Wagner, Nancy B.</creatorcontrib><creatorcontrib>Quigley, Peter S.</creatorcontrib><creatorcontrib>Grande, Peer</creatorcontrib><creatorcontrib>Wagner, Galen S.</creatorcontrib><title>Importance of early and complete reperfusion to achieve myocardial salvage after thrombolysis in acute myocardial infarction</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>The importance of the timing and completeness of coronary artery reperfusion for limitation of acute myocardial infarction (AMI) size after intravenous thrombolytic therapy was studied in 39 patients. All had electrocardiographic epicardial injury and acute coronary angiography performed <8 hours after symptom onset. Acutely jeopardized myocardium was estimated at baseline, and before and after angiography by quantitative ST-segment analysis. The AMI size was estimated on the final electrocardiogram by the Selvester QRS score. Left ventricular ejection fraction was measured at the time of acute angiography and before discharge in 31 of these patients. In the 21 patients with normal flow (Thrombolysis in Myocardial Infarction [TIMI] trial grade 3) in the infarct-related artery, the amount of jeopardized myocardium decreased from baseline to that before and after angiography (17 to 11 and 11%, respectively; p <0.00005), and the median final AMI size was reduced (17 to 9%; p = 0.0004). In 6 patients with suboptimal flow (TIMI grade 2), the median amount of jeopardized myocardium decreased slightly from baseline to that before to after angiography (15 to 12%); however, the median final AMI size was not reduced (17%). In 12 patients with no reperfusion (TIMI 0 to 1) flow, the median amount of jeopardized myocardium remained unchanged from baseline to that before angiography (21%), and the final AMI size was not significantly reduced. There was a significant inverse correlation between the change in global left ventricular function and the difference between electrocardiographic estimated jeopardized and final AMI size (r
s = −0.53; p = 0.008). The final AMI size in the TIMI 3 group was 47% smaller than in the combined TIMI 0 to 1 and 2 groups (p = 0.057). These findings suggest that only early and complete AMI reperfusion will result in myocardial salvage.</description><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Coronary Angiography</subject><subject>Coronary heart disease</subject><subject>Coronary Vessels - pathology</subject><subject>Electrocardiography</subject><subject>Gated Blood-Pool Imaging</subject><subject>Heart</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myocardial Infarction - drug therapy</subject><subject>Myocardial Infarction - pathology</subject><subject>Myocardial Infarction - physiopathology</subject><subject>Myocardial Reperfusion</subject><subject>Myocardium - pathology</subject><subject>Streptokinase - therapeutic use</subject><subject>Stroke Volume - physiology</subject><subject>Thrombolytic Therapy</subject><subject>Tissue Plasminogen Activator - therapeutic use</subject><subject>Urokinase-Type Plasminogen Activator - therapeutic use</subject><subject>Vascular Patency</subject><subject>Ventricular Function, Left - physiology</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1992</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU2LFDEQhoMo67j6DxRykEUPvearM52LIIsfCwt70XOoTSpupLvTJumBAX_8ZphhxYunItTzvoSnCHnN2SVnXH9gjInOcGXeGfHeMDFsO_OEbPiwNR03XD4lm0fkOXlRyq_25LzXZ-SMKyU00xvy53paUq4wO6QpUIQ87inMnro0LSNWpBkXzGEtMc20JgruPuIO6bRPDrKPMNIC4w5-IoVQMdN6n9N0l8Z9iYXGuQXW-g8e5wDZ1db3kjwLMBZ8dZrn5MeXz9-vvnU3t1-vrz7ddE4OunYibB066blUHgKDXhodtHfDgEI7IxGF6blA1KbxxmtUYAbt0QnhmQvynFwce5ecfq9Yqp1icTiOMGNai91K2eteyQaqI-hyKiVjsEuOE-S95cwepNuDUXswak2bB-nWtNibU_96N6H_Gzpabvu3pz0UB2PITXcsj5hSmqtBNOzjEcPmYhcx2-Iitsv4mNFV61P8_z8eAAvIoNU</recordid><startdate>19921201</startdate><enddate>19921201</enddate><creator>Clemmensen, Peter</creator><creator>Ohman, E.Magnus</creator><creator>Sevilla, Dorina C.</creator><creator>Wagner, Nancy B.</creator><creator>Quigley, Peter S.</creator><creator>Grande, Peer</creator><creator>Wagner, Galen S.</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19921201</creationdate><title>Importance of early and complete reperfusion to achieve myocardial salvage after thrombolysis in acute myocardial infarction</title><author>Clemmensen, Peter ; Ohman, E.Magnus ; Sevilla, Dorina C. ; Wagner, Nancy B. ; Quigley, Peter S. ; Grande, Peer ; Wagner, Galen S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c386t-2f7cec3d134daf0a5396f6dc88e26c93ee29512ee693869d6e4a986dec22d0cf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1992</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Coronary Angiography</topic><topic>Coronary heart disease</topic><topic>Coronary Vessels - pathology</topic><topic>Electrocardiography</topic><topic>Gated Blood-Pool Imaging</topic><topic>Heart</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Myocardial Infarction - drug therapy</topic><topic>Myocardial Infarction - pathology</topic><topic>Myocardial Infarction - physiopathology</topic><topic>Myocardial Reperfusion</topic><topic>Myocardium - pathology</topic><topic>Streptokinase - therapeutic use</topic><topic>Stroke Volume - physiology</topic><topic>Thrombolytic Therapy</topic><topic>Tissue Plasminogen Activator - therapeutic use</topic><topic>Urokinase-Type Plasminogen Activator - therapeutic use</topic><topic>Vascular Patency</topic><topic>Ventricular Function, Left - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Clemmensen, Peter</creatorcontrib><creatorcontrib>Ohman, E.Magnus</creatorcontrib><creatorcontrib>Sevilla, Dorina C.</creatorcontrib><creatorcontrib>Wagner, Nancy B.</creatorcontrib><creatorcontrib>Quigley, Peter S.</creatorcontrib><creatorcontrib>Grande, Peer</creatorcontrib><creatorcontrib>Wagner, Galen S.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Clemmensen, Peter</au><au>Ohman, E.Magnus</au><au>Sevilla, Dorina C.</au><au>Wagner, Nancy B.</au><au>Quigley, Peter S.</au><au>Grande, Peer</au><au>Wagner, Galen S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Importance of early and complete reperfusion to achieve myocardial salvage after thrombolysis in acute myocardial infarction</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>1992-12-01</date><risdate>1992</risdate><volume>70</volume><issue>18</issue><spage>1391</spage><epage>1396</epage><pages>1391-1396</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>The importance of the timing and completeness of coronary artery reperfusion for limitation of acute myocardial infarction (AMI) size after intravenous thrombolytic therapy was studied in 39 patients. All had electrocardiographic epicardial injury and acute coronary angiography performed <8 hours after symptom onset. Acutely jeopardized myocardium was estimated at baseline, and before and after angiography by quantitative ST-segment analysis. The AMI size was estimated on the final electrocardiogram by the Selvester QRS score. Left ventricular ejection fraction was measured at the time of acute angiography and before discharge in 31 of these patients. In the 21 patients with normal flow (Thrombolysis in Myocardial Infarction [TIMI] trial grade 3) in the infarct-related artery, the amount of jeopardized myocardium decreased from baseline to that before and after angiography (17 to 11 and 11%, respectively; p <0.00005), and the median final AMI size was reduced (17 to 9%; p = 0.0004). In 6 patients with suboptimal flow (TIMI grade 2), the median amount of jeopardized myocardium decreased slightly from baseline to that before to after angiography (15 to 12%); however, the median final AMI size was not reduced (17%). In 12 patients with no reperfusion (TIMI 0 to 1) flow, the median amount of jeopardized myocardium remained unchanged from baseline to that before angiography (21%), and the final AMI size was not significantly reduced. There was a significant inverse correlation between the change in global left ventricular function and the difference between electrocardiographic estimated jeopardized and final AMI size (r
s = −0.53; p = 0.008). The final AMI size in the TIMI 3 group was 47% smaller than in the combined TIMI 0 to 1 and 2 groups (p = 0.057). These findings suggest that only early and complete AMI reperfusion will result in myocardial salvage.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>1442606</pmid><doi>10.1016/0002-9149(92)90287-9</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0002-9149 |
| ispartof | The American journal of cardiology, 1992-12, Vol.70 (18), p.1391-1396 |
| issn | 0002-9149 1879-1913 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_73356543 |
| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Adult Aged Biological and medical sciences Cardiology. Vascular system Coronary Angiography Coronary heart disease Coronary Vessels - pathology Electrocardiography Gated Blood-Pool Imaging Heart Humans Medical sciences Middle Aged Myocardial Infarction - drug therapy Myocardial Infarction - pathology Myocardial Infarction - physiopathology Myocardial Reperfusion Myocardium - pathology Streptokinase - therapeutic use Stroke Volume - physiology Thrombolytic Therapy Tissue Plasminogen Activator - therapeutic use Urokinase-Type Plasminogen Activator - therapeutic use Vascular Patency Ventricular Function, Left - physiology |
| title | Importance of early and complete reperfusion to achieve myocardial salvage after thrombolysis in acute myocardial infarction |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-04T16%3A31%3A17IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Importance%20of%20early%20and%20complete%20reperfusion%20to%20achieve%20myocardial%20salvage%20after%20thrombolysis%20in%20acute%20myocardial%20infarction&rft.jtitle=The%20American%20journal%20of%20cardiology&rft.au=Clemmensen,%20Peter&rft.date=1992-12-01&rft.volume=70&rft.issue=18&rft.spage=1391&rft.epage=1396&rft.pages=1391-1396&rft.issn=0002-9149&rft.eissn=1879-1913&rft.coden=AJCDAG&rft_id=info:doi/10.1016/0002-9149(92)90287-9&rft_dat=%3Cproquest_cross%3E73356543%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=73356543&rft_id=info:pmid/1442606&rft_els_id=0002914992902879&rfr_iscdi=true |