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European Heart Journal 1992 13(6):770-775;
Copyright © 1992 by the European Society of Cardiology.
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© 1992 The European Society of Cardiology

Thrombolysis and coronary occlusion: effects upon the non-infarct zone

R. CRANSWICK, G. CARTER, N. WILKES and G. NELSON

TICO Working Group, Royal North Shore Hospital St Leonards, Sydney, Australia 2065

Received 2 April 1991; revised 6 August 1991; .

Correspondence: Dr Gregory Nelson FRACP, Senior Staff Cardiologist, Royal North Shore Hospital, St Leonards, Sydney, Australia 2065.

Abstract

Regional wall motion was examined by angiography after 3 weeks in 154 patients taking part in the Thrombolysis in Coronary Occlusion (TICO) Trial. Coronary patency rate was greater after administration of recombinant tissue plasminogen activator, (rt-PA 62/77pts 81%) than after a placebo (P 49/77pts 64% P = 0.02), particularly for the left anterior descending artery compared with the right coronary artery (LAD 27/28 96% vs RCA 28/40 70% P=0.006). Left ventricular ejection fraction (LVEF) was preserved after rt-PA (rt-PA 59 ±14% vs P53±15% P = 0.01), predominantly because of more effective non-infarct zone contraction (rt-PA 0.52± 1.16 SD/cord vs P 1.01±1.07 SD/cordP=0.008). Infarct zone scores differed little (rt-PA 2.88 ±0.95 SD/cord vs P 3.16±1.11 SD/cordP=0.09). Left ventricular ejection fraction and non-infarct zone function were best pre•erved after rt-PA compared with the placebo, particularly in patients with single vessel disease and in patients in whom the infarct-related artery was the left anterior descending vessel.

Key Words: Myocardial infarction • thrombolysis • regional wall motion • rt-PA


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