Early Treatment of Acute Myocardial Infarction With Intravenous Streptokinase: A High-Risk Syndrome

Gideon Koren, Myron H. Luria, Avraham T. Weiss, Michael Kriwisky, Morris Mosseri, Chaim Lotan, David Applebaum, Sima Welber, Dan Sapoznikov, Yosef Ben David, Yonathan Hasin, Mervyn S. Gotsman*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Fifty-one successive patients treated with intravenous streptokinase 1.7 ±0.8 (mean ± SD) hours after onset of symptoms of acute myocardial infarction were evaluated during a three-month posthospital follow-up period. Coronary angiography was performed four to nine days after the initial hospital admission. Twenty-eight patients had a second late angiogram. Forty-one patients had successful reperfusion but only 25% of all patients were without significant clinical cardiovascular manifestations during this period. Postmyocardial infarction angina pectoris occurred in 21 patients, an abnormal stress test result was present in 28 patients, eight patients developed congestive heart failure, and five patients had reinfarction. An intervention with percutaneous transluminal coronary angioplasty or coronary artery bypass graft was performed in 15 (37%) of 41 reperfused patients. A significantly higher intervention rate was present in patients treated with streptokinase within one hour following the onset of symptoms. Early reocclusion (within three months of the infarct) was noted in patients with 60% or more residual stenosis in their infarct-related coronary artery. These patients also had a significantly greater incidence of angina pectoris. Our findings indicate that early thrombolytic therapy of acute myocardial infarction preserves myocardium, and since the infarct-related artery is patent, but narrowed, the jeopardized area is responsible for a high-risk syndrome with an increased likelihood of ischemic symptoms. An early aggressive approach may be indicated, especially for patients with greater than 60% residual stenosis in their infarct-related coronary artery.

Original languageEnglish
Pages (from-to)237-240
Number of pages4
JournalArchives of Internal Medicine
Issue number2
StatePublished - Feb 1987
Externally publishedYes


Dive into the research topics of 'Early Treatment of Acute Myocardial Infarction With Intravenous Streptokinase: A High-Risk Syndrome'. Together they form a unique fingerprint.

Cite this