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European Heart Journal 1994 15(5):699-704;
Copyright © 1994 by the European Society of Cardiology.
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© 1994 The European Society of Cardiology

Effects of streptokinase on infarct size in rabbits in the presence and absence of coronary artery recanalization

S. CHAKRABARTY, D. S. FLUCK, N. A. FLORES and D. J. SHERIDAN

Academic Cardiology Unit, St. Mary's Hospital Medical School London W2 1NY, U.K

Received 1 July 1992; revised 15 December 1993; .

Correspondence. Professor D. J. Sheridan, Academic Cardiology Unit, St. Mary's Hospital Medical School, QEQM Wing, South Wharf Road, London W2 1NY, U.K.

Abstract

Despite variable efficacy in achieving recanalization, different thrombolytic agents demonstrate similar abilities to reduce mortality following myocardial infarction. We investigated whether factors other than the ability to achieve coronary artery recanalization are important in mediating the beneficial effects associated with thrombolytic therapy during acute myocardial infarction using anaesthetized rabbits.

Coronary artery occlusion was produced using either a single ligature (which was released to initiate reperfusion) or by placing two ligatures 5 mm apart to allow the formation of an intraluminal thrombus. In this case, ligature removal followed by thrombolysis was required for recanalization- to occur. Experiments were performed in the presence and absence of streptokinase.

Streptokinase was most effective in reducing myocardial necrosis when associated with thrombolytic recanalization (total left ventricular infarct size was reduced from 37 ± 7% to 13 ± 1%, P<0.01). However, streptokinase also reduced infarct size in the absence of reperfusion (45 ± 4% vs 35 ± 2%, P<0.05), although further work is needed to clarify the mechanisms.

Key Words: Myocardial infarction • ischaemia • reperfusion • thrombolytic therapy • streptokinase • cardiac output • ligation


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