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Previous Volume 329:1615-1622 November 25, 1993 Number 22 Next

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ABSTRACT

Background Although it is known that thrombolytic therapy improves survival after acute myocardial infarction, it has been debated whether the speed with which coronary-artery patency is restored after the initiation of therapy further affects outcome.

Methods To study this question, we randomly assigned 2431 patients to one of four treatment strategies for reperfusion: streptokinase with subcutaneous heparin; streptokinase with intravenous heparin; accelerated-dose tissue plasminogen activator (t-PA) with intravenous heparin; or a combination of both activators plus intravenous heparin. Patients were also randomly assigned to cardiac angiography at one of four times after the initiation of thrombolytic therapy: 90 minutes, 180 minutes, 24 hours, or 5 to 7 days. The group that underwent angiography at 90 minutes underwent it again after 5 to 7 days.

Results The rate of patency of the infarct-related artery at 90 minutes was highest in the group given accelerated-dose t-PA and heparin (81 percent), as compared with the group given streptokinase and subcutaneous heparin (54 percent, P<0.001), the group given streptokinase and intravenous heparin (60 percent, P<0.001), and the group given combination therapy (73 percent, P = 0.032). Flow through the infarct-related artery at 90 minutes was normal in 54 percent of the group given t-PA and heparin but in less than 40 percent of the three other groups (P<0.001). By 180 minutes, the patency rates were the same in the four treatment groups. Reocclusion was infrequent and was similar in all four groups (range, 4.9 to 6.4 percent). Measures of left ventricular function paralleled the rate of patency at 90 minutes; ventricular function was best in the group given t-PA with heparin and in patients with normal flow through the infarct-related artery irrespective of treatment group. Mortality at 30 days was lowest (4.4 percent) among patients with normal coronary flow at 90 minutes and highest (8.9 percent) among patients with no flow (P = 0.009).

Conclusions This study supports the hypothesis that more rapid and complete restoration of coronary flow through the infarct-related artery results in improved ventricular performance and lower mortality among patients with myocardial infarction. This would appear to be the mechanism by which accelerated t-PA therapy produced the most favorable outcome in the GUSTO trial.

Source Information

Dr. Ross, as chairman of the GUSTO Angiographic Study, assumes full responsibility for the overall content and integrity of the manuscript.A list of the GUSTO (Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries) angiographic investigators appears in the Appendix.

Address reprint requests to Dr. Allan M. Ross at the Division of Cardiology, George Washington University, 2150 Pennsylvania Ave., NW, Washington, DC 20037.

Full Text of this Article

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Thrombolytic Therapy for Myocardial Infarction
Montgomery H., Speechly-Dick M.E., Pechlaner C., Lechleitner P., Ross A. M.
Extract | Full Text  
N Engl J Med 1994; 330:1089-1090, Apr 14, 1994. Correspondence

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• Tadros, G. M., Islam, M. A., Mirza, A., Blankenship, J. C., Iliadis, E. A. (2004). Angiographic and Long-Term Outcomes of "Rescue" Stenting versus PTCA in Failed Thrombolysis in Acute Myocardial Infarction. ANGIOLOGY 55: 169-176 [Abstract]  
• Chaudhuri, A., Janicke, D., Wilson, M. F., Tripathy, D., Garg, R., Bandyopadhyay, A., Calieri, J., Hoffmeyer, D., Syed, T., Ghanim, H., Aljada, A., Dandona, P. (2004). Anti-Inflammatory and Profibrinolytic Effect of Insulin in Acute ST-Segment-Elevation Myocardial Infarction. Circulation 109: 849-854 [Abstract] [Full Text]  
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• Keeley, E. C., Grines, C. L. (2004). Primary Coronary Intervention for Acute Myocardial Infarction. JAMA 291: 736-739 [Full Text]  
• Lee, S., Otsuji, Y., Minagoe, S., Hamasaki, S., Toyonaga, K., Negishi, M., Tsurugida, M., Toda, H., Tei, C. (2003). Noninvasive Evaluation of Coronary Reperfusion by Transthoracic Doppler Echocardiography in Patients With Anterior Acute Myocardial Infarction Before Coronary Intervention. Circulation 108: 2763-2768 [Abstract] [Full Text]  
• Mehta, R. H., Harjai, K. J., Cox, D., Stone, G. W., Brodie, B., Boura, J., O'Neill, W., Grines, C. L., Primary Angioplasty in Myocardial Infarction (PAMI, (2003). Clinical and angiographic correlates and outcomes of suboptimal coronary flow inpatients with acute myocardial infarction undergoing primary percutaneous coronary intervention. J Am Coll Cardiol 42: 1739-1746 [Abstract] [Full Text]  
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• Hozumi, T, Kanzaki, Y, Ueda, Y, Yamamuro, A, Takagi, T, Akasaka, T, Homma, S, Yoshida, K, Yoshikawa, J (2003). Coronary flow velocity analysis during short term follow up after coronary reperfusion: use of transthoracic Doppler echocardiography to predict regional wall motion recovery in patients with acute myocardial infarction. Heart 89: 1163-1168 [Abstract] [Full Text]  
• Scheller, B., Hennen, B., Hammer, B., Walle, J., Hofer, C., Hilpert, V., Winter, H., Nickenig, G., Bohm, M., SIAM III Study Group, (2003). Beneficial effects of immediate stenting after thrombolysis in acute myocardial infarction. J Am Coll Cardiol 42: 634-641 [Abstract] [Full Text]  
• McKay, R. G. (2003). Evolving strategies in the treatment of acute myocardial infarction in the community hospital setting. J Am Coll Cardiol 42: 642-645 [Full Text]  
• Wallentin, L., Goldstein, P., Armstrong, P.W., Granger, C.B., Adgey, A.A.J., Arntz, H.R., Bogaerts, K., Danays, T., Lindahl, B., Makijarvi, M., Verheugt, F., Van de Werf, F. (2003). Efficacy and Safety of Tenecteplase in Combination With the Low-Molecular-Weight Heparin Enoxaparin or Unfractionated Heparin in the Prehospital Setting: The Assessment of the Safety and Efficacy of a New Thrombolytic Regimen (ASSENT)-3 PLUS Randomized Trial in Acute Myocardial Infarction. Circulation 108: 135-142 [Abstract] [Full Text]  
• Topaz, O., Perin, E. C., Jesse, R. L., Mohanty, P. K., Carr, M., Rosenschein, U. (2003). Power Thrombectomy in Acute Ischemic Coronary Syndromes. ANGIOLOGY 54: 457-468 [Abstract]  
• Wu, S.-C., Castellino, F. J., Wong, S.-L. (2003). A Fast-acting, Modular-structured Staphylokinase Fusion with Kringle-1 from Human Plasminogen as the Fibrin-targeting Domain Offers Improved Clot Lysis Efficacy. J. Biol. Chem. 278: 18199-18206 [Abstract] [Full Text]  
• Wallentin, L., Bergstrand, L., Dellborg, M., Fellenius, C., Granger, C. B, Lindahl, B., Lins, L.-E., Nilsson, T., Pehrsson, K., Siegbahn, A., Swahn, E., for the ASSENT PLUS Investigators, (2003). Low molecular weight heparin (dalteparin) compared to unfractionated heparin as an adjunct to rt-PA (alteplase) for improvement of coronary artery patency in acute myocardial infarction--the ASSENT Plus study. Eur Heart J 24: 897-908 [Abstract] [Full Text]  
• Giugliano, R. P., Roe, M. T., Harrington, R. A., Gibson, C. M., Zeymer, U., Van de Werf, F., Baran, K. W., Hobbach, H.-P., Woodlief, L. H., Hannan, K. L., Greenberg, S., Miller, J., Kitt, M. M., Strony, J., McCabe, C. H., Braunwald, E., Califf, R. M., the INTEGRITI Investigators, (2003). Combination reperfusion therapy with eptifibatide and reduced-dose tenecteplase for ST-elevation myocardial infarction: Results of the integrilin and tenecteplase in acute myocardial infarction (INTEGRITI) Phase II Angiographic urial. J Am Coll Cardiol 41: 1251-1260 [Abstract] [Full Text]  
• Haager, P. K., Christott, P., Heussen, N., Lepper, W., Hanrath, P., Hoffmann, R. (2003). Prediction of clinical outcome after mechanical revascularization in acute myocardial infarction by markers of myocardial reperfusion. J Am Coll Cardiol 41: 532-538 [Abstract] [Full Text]  
• Moliterno, D. J., Chan, A. W. (2003). Glycoprotein IIb/IIIa inhibition in early intent-to-stent treatment of acute coronary syndromes: EPISTENT, ADMIRAL, CADILLAC, and TARGET. J Am Coll Cardiol 41: 49S-54S [Abstract] [Full Text]  
• Mathew, T.P., Menown, I.B.A., McCarty, D., Gracey, H., Hill, L., Adgey, A.A.J. (2003). Impact of pre-hospital care in patients with acute myocardial infarction compared with those first managed in-hospital. Eur Heart J 24: 161-171 [Abstract] [Full Text]  
• Petronio, A.S, Rovai, D, Musumeci, G, Baglini, R, Nardi, C, Limbruno, U, Palagi, C, Volterrani, D, Mariani, M (2003). Effects of abciximab on microvascular integrity and left ventricular functional recovery in patients with acute infarction treated by primary coronary angioplasty. Eur Heart J 24: 67-76 [Abstract] [Full Text]  
• Lee, D. C., Ting, W., Oz, M. C. (2003). Myocardial Revascularization after Acute Myocardial Infarction. Card Surg Adult 2: 639-658 [Full Text]  
• Dixon, S. R., Whitbourn, R. J., Dae, M. W., Grube, E., Sherman, W., Schaer, G. L., Jenkins, J. S., Baim, D. S., Gibbons, R. J., Kuntz, R. E., Popma, J. J., Nguyen, T. T., O'Neill, W. W. (2002). Induction of mild systemic hypothermia with endovascular cooling during primary percutaneous coronary intervention for acute myocardial infarction. J Am Coll Cardiol 40: 1928-1934 [Abstract] [Full Text]  
• Beanlands, R. S. B., Ruddy, T. D., deKemp, R. A., Iwanochko, R. M., Coates, G., Freeman, M., Nahmias, C., Hendry, P., Burns, R. J., Lamy, A., Mickleborough, L., Kostuk, W., Fallen, E., Nichol, G., PARR Investigators, (2002). Positron emission tomography and recovery following revascularization (PARR-1): the importance of scar and the development of a prediction rule for the degree of recovery of left ventricular function. J Am Coll Cardiol 40: 1735-1743 [Abstract] [Full Text]  
• Lincoff, A. M., Califf, R. M., Van de Werf, F., Willerson, J. T., White, H. D., Armstrong, P. W., Guetta, V., Gibler, W. B., Hochman, J. S., Bode, C., Vahanian, A., Steg, P. G., Ardissino, D., Savonitto, S., Bar, F., Sadowski, Z., Betriu, A., Booth, J. E., Wolski, K., Waller, M., Topol, E. J., for the GUSTO V Investigators, (2002). Mortality at 1 Year With Combination Platelet Glycoprotein IIb/IIIa Inhibition and Reduced-Dose Fibrinolytic Therapy vs Conventional Fibrinolytic Therapy for Acute Myocardial Infarction: GUSTO V Randomized Trial. JAMA 288: 2130-2135 [Abstract] [Full Text]  
• Buxton, A. E., Lee, K. L., Hafley, G. E., Wyse, D. G., Fisher, J. D., Lehmann, M. H., Pires, L. A., Gold, M. R., Packer, D. L., Josephson, M. E., Prystowsky, E. N., Talajic, M. R., for the MUSTT Investigators, (2002). Relation of Ejection Fraction and Inducible Ventricular Tachycardia to Mode of Death in Patients With Coronary Artery Disease: An Analysis of Patients Enrolled in the Multicenter Unsustained Tachycardia Trial. Circulation 106: 2466-2472 [Abstract] [Full Text]  
• Krombach, G. A., Wendland, M. F., Higgins, C. B., Saeed, M. (2002). MR Imaging of Spatial Extent of Microvascular Injury in Reperfused Ischemically Injured Rat Myocardium: Value of Blood Pool Ultrasmall Superparamagnetic Particles of Iron Oxide. Radiology 225: 479-486 [Abstract] [Full Text]  
• Bolognese, L., Neskovic, A. N., Parodi, G., Cerisano, G., Buonamici, P., Santoro, G. M., Antoniucci, D. (2002). Left Ventricular Remodeling After Primary Coronary Angioplasty: Patterns of Left Ventricular Dilation and Long-Term Prognostic Implications. Circulation 106: 2351-2357 [Abstract] [Full Text]  
• Baker, W. F. Jr (2002). Thrombolytic Therapy. CLIN APPL THROMB HEMOST 8: 291-314  
• Ronner, E., van Domburg, R.T., van den Brand, M.J.B.M., de Feyter, P.J., Foley, D.P., van der Giessen, W.J., Serruys, P.W., Simoons, M.L. (2002). Platelet GP IIb/IIIa receptor blockers for failed thrombolysis in acute myocardial infarction, alone or as adjunct to other rescue therapies. A single centre retrospective analysis of 548 consecutive patients with acute myocardial infarction. Eur Heart J 23: 1529-1537 [Abstract] [Full Text]  
• Yip, H.-K., Chen, M.-C., Chang, H.-W., Hang, C.-L., Hsieh, Y.-K., Fang, C.-Y., Wu, C.-J. (2002). Angiographic Morphologic Features of Infarct-Related Arteries and Timely Reperfusion in Acute Myocardial Infarction: Predictors of Slow-Flow and No-Reflow Phenomenon. Chest 122: 1322-1332 [Abstract] [Full Text]  
• Wright, R. S., Reeder, G. S., Herzog, C. A., Albright, R. C., Williams, B. A., Dvorak, D. L., Miller, W. L., Murphy, J. G., Kopecky, S. L., Jaffe, A. S. (2002). Acute Myocardial Infarction and Renal Dysfunction: A High-Risk Combination. ANN INTERN MED 137: 563-570 [Abstract] [Full Text]  
• Rothenburger, M., Wilhelm, M. J., Hammel, D., Schmidt, C., Tjan, T. D. T., Bocker, D., Scheld, H. H., Schmid, C. (2002). Treatment of Thrombus Formation Associated With the MicroMed DeBakey VAD Using Recombinant Tissue Plasminogen Activator. Circulation 106: I-189-I-192 [Abstract] [Full Text]