Late Thrombolytic Therapy Preserves Left Ventricular Function in Patients
View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Elsevier - Publisher Connector 58 JACC Vol . 14, No . I July 18 58-64 Late Thrombolytic Therapy Preserves Left Ventricular Function in Patients With Collateralized Total Coronary Occlusion Primary End Point Findings of the Second Mount Sinai-New York University Reperfusion Trial K. PETER RENTROP, MD, FACC,* FREDERICK FELT, MD, FACC,t WARREN SHERMAN, MD, FACC,* PETER STECY, MD, FACC,t SUSAN HOSAT, MS,* MARC COHEN, MD, FACC,* MARIANO REY, MD, FACC,t JOHN AMBROSE, MD, FACC,* MARK NACHAMIE, MD,t WILLIAM SCHWARTZ, MD, FACC,* WILLIAM COLE, MD,t ROBERT PERDONCIN, MD,* JOHN C . THORNTON, PHD New York, New York The change in left ventricular ejection fraction from prein- icant improvement over those without collateral flow in the tervention to predischarge was prospectively assessed in streptokinase (5 .4 ± 2.5%) and streptokinase-nitroglycerin 33 patients with acute myocardial infarction . Within 12 h (10 .6 ± 2 .7 %) arms, but not in the nitroglycerin arm . Time of symptom onset (mean 6.3 ± 2 .7 h), patients were to treatment did not influence the change in ejection randomly assigned to a double-blind intracoronary infusion fraction . In patients with initial subtotal occlusion, throm- of streptokinase, nitroglycerin, both streptokinase and ni- bolytic therapy was of no short-term benefit because ejec- troglycerin or conventional therapy without acute cardiac tion fraction increased by 6% in all three intervention catheterization . Treatment effects were also assessed in arms. prospectively defined angiographic subsets . These findings indicate that relatively late thrombolytic There was a significant interaction between streptoki- therapy results in significant myocardial salvage in those nase and nitroglycerin (p < 0 .01), resulting in an increase patients with collateralized total coronary occlusion .
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