tailieunhanh - Intracoronary Streptokinase after Primary Percutaneous Coronary Intervention

Microvascular perfusion is often impaired after primary percutaneous coronary intervention (PCI). We proposed that in situ thrombosis might contribute to poor myocardial perfusion in this setting. To test this hypothesis, we evaluated the effect of lowdose intracoronary streptokinase administered immediately after primary PCI. Methods Forty-one patients undergoing primary PCI were randomly assigned to receive intracoronary streptokinase (250 kU) or no additional therapy. | Intracoronary Streptokinase after Primary Percutaneous Coronary Intervention Intracoronary Streptokinase after Primary Percutaneous Coronary Intervention Murat Sezer . Huseyin Oflaz . Taner Goren . irem Okẹular . Berrin Umman . Yilmaz Niặanci . Ahmet Kaya Bilge . Yasemin Ẹanli . Mehmet Meriẹ . and Sabahattin Umman . abstract background Microvascular perfusion is often impaired after primary percutaneous coronary intervention PCI . We proposed that in situ thrombosis might contribute to poor myocardial perfusion in this setting. To test this hypothesis we evaluated the effect of low-dose intracoronary streptokinase administered immediately after primary PCI. methods Forty-one patients undergoing primary PCI were randomly assigned to receive intracoronary streptokinase 250 kU or no additional therapy. Two days later cardiac catheterization was repeated and coronary hemodynamic end points were measured with the use of a guidewire tipped with pressure and temperature sensors. In patients with anterior myocardial infarction the deceleration time of coronary diastolic flow was measured with transthoracic echocardiography. At 6 months angiography echocardiography and technetium-99m single-photon-emission computed tomography were performed. From the Istanbul Faculty of Medicine Istanbul University Istanbul Turkey. Address reprint requests to Dr. Sezer at Istanbul University Istanbul Faculty of Medicine Department of Cardiology Istanbul Turkey or at sezerm@. N Engl J Med 2007 356 1823-34. Copyright 2007 Massachusetts Medical Society. results Two days after PCI all measures of microvascular function means SD were significantly better in the streptokinase group than in the control group including coronary flow reserve vs. the index of microvascular resistance U vs. U the collateral-flow index vs. mean coronary wedge pressure mm Hg vs. mm Hg .

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