Coronary artery reperfusion in XXXX : beneficial effects of intracoronary streptokinase on left ventricular salvage and performance.

@entity1 @entity4214 @entity1188 @entity432 @entity583
Coronary angiography was performed on hospital admission in 37 @entity1 with @entity583 ( @entity583 ). Thirty @entity1 had @entity432 of the @entity1188 -related coronary artery and seven @entity1 had severe proximal stenoses with poor distal flow. In 20 of 30 @entity1 with @entity432 , intracoronary (IC) infusion of streptokinase (SK) resulted in reperfusion of the distal coronary artery. Left ventricular (LV) performance was assessed before coronary angiography and at discharge from the hospital by use of gated cardiac blood pool imaging techniques. In @entity1 evidencing reperfusion of the @entity1188 -related coronary artery, mean (+/- SD) left ventricular ejection fraction (LVEF) increased from admission through discharge (46% +/- 15% to 55% +/- 10%, p = 0.002). In contrast, LVEF did not change from admission through discharge in @entity1 with severe proximal stenoses alone or in @entity1 with @entity432 who did not demonstrate reperfusion following SK administration (47% +/- 17% vs 49% +/- 18%, p = ns). In an additional 14 control @entity1 with @entity583 who were not evaluated with coronary angiography, LVEF did not change from admission through discharge (46% +/- 12% vs 48% +/- 14%, p = ns). Quantitative @entity4214 -201 perfusion imaging demonstrated an increase (p less than 0.05) in @entity4214 uptake in the @entity1188 segment following coronary artery reperfusion. In contrast, @entity4214 uptake did not change (p = ns) in the @entity1188 segment in @entity1 not evidencing angiographic coronary artery reperfusion. These data support the following : (1) Coronary artery thrombus occurs frequently in @entity583 and can be lysed by IC SK, and (2) reperfusion with IC SK in @entity1 with evolving @entity583 results in myocardial salvage and improved LV performance through hospital discharge.
