Clinical and laboratory signs of reperfusion: are they reliable?
We studied 101 patients (88 men and 13 women, mean age 54.5 ± 10 years) who arrived at the hospital during the first 6 hours of acute myocardial infarction evolution. Our objective was to assess the reliability of clinical and laboratory signs of recanalization using intravenous streptokinase as a t...
Gespeichert in:
Veröffentlicht in: | International journal of cardiology 1989-12, Vol.25 (3), p.313-320 |
---|---|
Hauptverfasser: | , , , , , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
Zusammenfassung: | We studied 101 patients (88 men and 13 women, mean age 54.5 ± 10 years) who arrived at the hospital during the first 6 hours of acute myocardial infarction evolution. Our objective was to assess the reliability of clinical and laboratory signs of recanalization using intravenous streptokinase as a thrombolytic agent. The mean time between the beginning of infusion and coronary arteriography was 53.83 ± 43 hours. The positive predictive values for pain, arrhythmia, ST segment and enzymes were 97.9%, 94.2%, 91.8% and 90.8%, respectively; the negative predictive values were 46.8%, 40.8%, 37.2% and 50% in the same order. Sensitivity was 65.7%, 62.8%, 58.4% and 77.6% and specificity 95.6%, 86.9%, 82.6% and 73.9%, respectively. The positive predictive value, calculated on the basis of the presence of each variable alone or in association showed a probability of recanalization of 76.9% for one sign, 84% for two, 96.3% for three and 100% for all four. When we compared the positive predictive values of each variable according to the interval between the beginning of pain and admission to the hospital (during the first 3 hours or between 3 and 6 hours) our results were
100%
94%
for pain (
P = NS),
97%
88%
for arrhythmia (
P = NS),
100%
75%
for ST segment (
P = 0.004), and
97%
80%
for enzymes (
P = 0.019). The same analysis applied to negative predictive values showing
22%
62%
(
P = 0.007),
17%
55%
(
P = 0.008),
21%
47%
(
P = NS),
27%
61%
(
P = NS) for pain, arrhythmia, ST segment and enzymes, respectively.
From these data we concluded that these signs are not ideal but sufficiently reliable as indicators of recanalization post-intravenous streptokinase, especially when 3 or 4 of them are present, or when they appear in patients within 3 hours post-infarction. |
---|---|
ISSN: | 0167-5273 1874-1754 |
DOI: | 10.1016/0167-5273(89)90221-0 |