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European Heart Journal 1987 8(11):1182-1188;
Copyright © 1987 by the European Society of Cardiology.
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© 1987 The European Society of Cardiology

Residual coronary stenosis after thrombolysis with rt-PA or streptokinase: acute results and 3 weeks follow-up

W. G. SCHMIDT, R. UEBIS, R. V. ESSEN, S. EFFERT, R. ERBEL*, J. MEYER*, W. RURSCH{dagger}, M. SCHARTL{dagger}, H. SCHMUTZLER{dagger} ON BEHALF OF THE EUROPEAN CO-OPERATIVE STUDY GROUP FOR RECOMBINANT TISSUE-TYPE PLASMINOGEN ACTIVATOR

Department of Internal Medicine 1
* RWTH Aachen, Department of Internal Medicine II, University of Mainz
{dagger} Department of Cardiology, Klinikun Charlottenburg, Free University Berlin, F.R.G.

Received 21 January 1987; revised 2 June 1987; .

Dr W. G. Schmidt, Dept. Int. Med I, RWTH Aachen, Pauwelsstrasse, D-5100 Aachen, F.R.G.

Ninety-one patients with acute myocardial infarction were assigned to intravenous treatment with streptokinase or rt-PA as part of the randomized trial carried out by the European Study Group for Recombinant Tissue-Type Plasminogen Activator (rt-PA). A patent coronary artery was found in 37 of 45 (82%) patients treated with rt-PA and in 27 of 46 (59%) patients treated with streptokinase 75–90 minutes after start of infusion. Patients were subsequently anticoagulated with heparin or dicoumarol up to a repeat angiography 3 weeks after the infarction.Of the 64 patients with successful reperfusion, 3 died and 3 suffered reocclusion of the vessel. Quantitative analysis of the coronary stenosis both immediately after thrombolvsis and at 3 weeks follow-up was possible in 33 cases. Residual stenosis (percentage narrowing of diameter) decreased from 74± 14% to 56± 17% P<0.05). No difference was observed between the groups of patients treated with streptokinase (74±9% to 57±12%, N = 17) and with rt-PA (74±17% to 56±21%, N = 16). Despite the significant regression, a coronary stenosis of more than 50% of the diameter persisted in 82% of the patients three weeks after the infarction.

Key Words: Myocardial infarction, • thrombolysis, • plasminogen activator, • coronary stenosis.


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D. Alexopoulos, C. Olympios, and G. Hahalis
Postinfarction Ventricular Septal Rupture Following Thrombolysis: Long-Term Survival in the Presence of Normal Coronary Arteries A Case Report
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[Abstract] [PDF]


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