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Late Results of Reperfusion with Intracoronary Streptokinase

  • Chapter
Secondary Prevention in Coronary Artery Disease and Myocardial Infarction

Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 48))

  • 48 Accesses

Abstract

The reasons for attempting to salvage myocardium threatened by ischemia during temporary or permanent occlusion of one of the nutrient arteries, such as after coronary thrombosis, is based on the observation that the major determinant of survival and the main reason for complications after recovery is the extent to which myocardium has been lost through infarction. Approaches proven to be of relevance under human clinical circumstances, fall into three groups: attempts to reduce the use of oxygen through pharmacological means when oxygen supply is jeopardized, attempts at restoring the blood supply and oxygen delivery at an early stage by manipulations on the coronary arteries and interventions aimed at reducing the dam-age of cardiac cells after onset of ischemia or during reperfusion. Endpoints considered to be proof of improved left ventricular performance will be: wall motion studies, ejection fraction measurements and reduction in death rate and other serious cardiovascular complications.

Studies involving beta blockers, calcium antagonists, prostaglandines and other pharmacological agents will be contrasted with results obtained from intracoronary thrombolysis through streptokinase and related products. In addition, results will be reported of vasodilator drugs such as nitrates and sodium nitroprusside. Although final proof from prospective randomized studies, one of which is carried out in our Institute and the Netherlands Interuniversitary Cardiological Institute, with Intracoronary streptokinase with 302 patients, will not be available at the time of this presentation, arguments will be provided which indicate that the second major approach i.e. restoration of blood supply at an early stage, preferably supported by pharmacological therapy with beta blockade and calcium antagonists, is to be preferred; inasmuch as current data indicate improved function and in certain subsets, improved life expectancy.

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Authors
  1. P. G. Hugenholtz
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  2. M. L. Simoons
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  3. P. W. Serruys
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  4. P. J. De Feyter
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  5. M. Van Den Brand
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  6. P. Fioretti
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Editor information

Editors and Affiliations

  1. Klinik Höhenried, Center for Cardiac Rehabilitation, Bernried (Obb.), Germany

    Peter Mathes

  2. Medical School, Technical University of Munich, Munich, Federal Republic of Germany

    Peter Mathes

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© 1985 Martinus Nijhoff Publishers, Dordrecht

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Hugenholtz, P.G., Simoons, M.L., Serruys, P.W., De Feyter, P.J., Van Den Brand, M., Fioretti, P. (1985). Late Results of Reperfusion with Intracoronary Streptokinase. In: Mathes, P. (eds) Secondary Prevention in Coronary Artery Disease and Myocardial Infarction. Developments in Cardiovascular Medicine, vol 48. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-5024-5_33

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  • DOI: https://doi.org/10.1007/978-94-009-5024-5_33

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-8725-4

  • Online ISBN: 978-94-009-5024-5

  • eBook Packages: Springer Book Archive

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