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Improved Left Ventricular Function in Myocardial Infarction Following Intravenous Thrombolytic Therapy with Acylated Plasminogen Activator

Department of Cardiology, Soroka Medical Center, and Faculty of Medical Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel

H. Silber

Department of Cardiology, Soroka Medical Center, and Faculty of Medical Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel

M.I. Hausman

Department of Cardiology, Soroka Medical Center, and Faculty of Medical Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel

G. Margolis

Department of Cardiology, Soroka Medical Center, and Faculty of Medical Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel

M. Gueron

Department of Cardiology, Soroka Medical Center, and Faculty of Medical Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel

Forty-six patients with acute myocardial infarction (MI) were treated within three hours of the onset of chest pain with an intravenous bolus (IV) of 30 units of anisolated plasminogen activator streptokinase complex (APSAC). Reperfusion was detected in 31 patients (67%) by clinical, electrocardiographic, and enzymatic criteria. The mean time elapsed between the onset of the chest pain to thrombolytic therapy was 114±53 minutes.

Left ventricular ejection fraction (LVEF) was significantly better in patients with anterior and inferior myocardial infarction who had successful reperfusion, as compared with those who did not (48.8 ±13.0 vs 35.3 ±10.9, p<0.05 and 59.7±12.6 vs 47.9±15.3, p<0.05, respectively). The rate of reocclusion within three weeks was 22%. The overall one-year mortality was 4%. There were no serious adverse reactions following the thrombolytic treatment. Thus bolus IV injection of 30 units of APSAC is both safe and effective in preserving left ventricular function when given early in the course of acute myocardial infarction.

Angiology, Vol. 41, No. 2, 133-138 (1990)
DOI: 10.1177/000331979004100207


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