Thrombolysis significantly reduces transient myocardial ischaemia following first acute myocardial infarction

H Mickley, P Pless, J R Nielsen, J Berning, M Møller

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Udgivelsesdato: 1992-Apr
OriginalsprogEngelsk
TidsskriftEuropean Heart Journal
Vol/bind13
Udgave nummer4
Sider (fra-til)484-90
Antal sider6
ISSN0195-668X
StatusUdgivet - 1. apr. 1992

Fingeraftryk

Exercise
Ambulatory Monitoring
Exercise Test

Citer dette

Mickley, H ; Pless, P ; Nielsen, J R ; Berning, J ; Møller, M. / Thrombolysis significantly reduces transient myocardial ischaemia following first acute myocardial infarction. I: European Heart Journal. 1992 ; Bind 13, Nr. 4. s. 484-90.
@article{6586af8046fd11df937d000ea68e967b,
title = "Thrombolysis significantly reduces transient myocardial ischaemia following first acute myocardial infarction",
abstract = "In order to investigate whether thrombolysis affects residual myocardial ischaemia, we prospectively performed a predischarge maximal exercise test and early out-of-hospital ambulatory ST segment monitoring in 123 consecutive men surviving a first acute myocardial infarction (AMI). Seventy-four patients fulfilled our criteria for thrombolysis, but only the last 35 patients included received thrombolytic therapy. As thrombolysis was not available in our Department at the start of the study, the first 39 patients included were conservatively treated (controls). No significant differences in baseline clinical characteristics were found between the two groups. In-hospital atrial fibrillation and digoxin therapy was more prevalent in controls (P less than 0.05). During exercise, thrombolysed patients reached a higher maximal work capacity compared with controls: 160 +/- 41 vs 139 +/- 34 W (P less than 0.02). Thrombolysis resulted in a non-significant reduction in exercise-induced ST segment depression: prevalence 43{\%} vs 62{\%} in controls. However, during ambulatory monitoring the duration of transient myocardial ischaemia was significantly reduced in thrombolysed patients: 322 min vs 1144 min in controls (P less than 0.05). Thrombolysed patients reached a higher heart rate during transient ischaemic episodes: 114 +/- 17 vs 93 +/- 11 b.min-1 in controls (P less than 0.001). In conclusion, thrombolytic therapy administered for a first AMI significantly reduces the burden of transient myocardial ischaemia. This may explain the improvement in myocardial function during physical activities, which was also observed in this study.",
keywords = "Coronary Circulation, Coronary Disease, Electrocardiography, Ambulatory, Exercise Test, Hemodynamics, Humans, Infusions, Intravenous, Myocardial Contraction, Myocardial Infarction, Prospective Studies, Retrospective Studies, Thrombolytic Therapy",
author = "H Mickley and P Pless and Nielsen, {J R} and J Berning and M M{\o}ller",
year = "1992",
month = "4",
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language = "English",
volume = "13",
pages = "484--90",
journal = "European Heart Journal",
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Thrombolysis significantly reduces transient myocardial ischaemia following first acute myocardial infarction. / Mickley, H; Pless, P; Nielsen, J R; Berning, J; Møller, M.

I: European Heart Journal, Bind 13, Nr. 4, 01.04.1992, s. 484-90.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Thrombolysis significantly reduces transient myocardial ischaemia following first acute myocardial infarction

AU - Mickley, H

AU - Pless, P

AU - Nielsen, J R

AU - Berning, J

AU - Møller, M

PY - 1992/4/1

Y1 - 1992/4/1

N2 - In order to investigate whether thrombolysis affects residual myocardial ischaemia, we prospectively performed a predischarge maximal exercise test and early out-of-hospital ambulatory ST segment monitoring in 123 consecutive men surviving a first acute myocardial infarction (AMI). Seventy-four patients fulfilled our criteria for thrombolysis, but only the last 35 patients included received thrombolytic therapy. As thrombolysis was not available in our Department at the start of the study, the first 39 patients included were conservatively treated (controls). No significant differences in baseline clinical characteristics were found between the two groups. In-hospital atrial fibrillation and digoxin therapy was more prevalent in controls (P less than 0.05). During exercise, thrombolysed patients reached a higher maximal work capacity compared with controls: 160 +/- 41 vs 139 +/- 34 W (P less than 0.02). Thrombolysis resulted in a non-significant reduction in exercise-induced ST segment depression: prevalence 43% vs 62% in controls. However, during ambulatory monitoring the duration of transient myocardial ischaemia was significantly reduced in thrombolysed patients: 322 min vs 1144 min in controls (P less than 0.05). Thrombolysed patients reached a higher heart rate during transient ischaemic episodes: 114 +/- 17 vs 93 +/- 11 b.min-1 in controls (P less than 0.001). In conclusion, thrombolytic therapy administered for a first AMI significantly reduces the burden of transient myocardial ischaemia. This may explain the improvement in myocardial function during physical activities, which was also observed in this study.

AB - In order to investigate whether thrombolysis affects residual myocardial ischaemia, we prospectively performed a predischarge maximal exercise test and early out-of-hospital ambulatory ST segment monitoring in 123 consecutive men surviving a first acute myocardial infarction (AMI). Seventy-four patients fulfilled our criteria for thrombolysis, but only the last 35 patients included received thrombolytic therapy. As thrombolysis was not available in our Department at the start of the study, the first 39 patients included were conservatively treated (controls). No significant differences in baseline clinical characteristics were found between the two groups. In-hospital atrial fibrillation and digoxin therapy was more prevalent in controls (P less than 0.05). During exercise, thrombolysed patients reached a higher maximal work capacity compared with controls: 160 +/- 41 vs 139 +/- 34 W (P less than 0.02). Thrombolysis resulted in a non-significant reduction in exercise-induced ST segment depression: prevalence 43% vs 62% in controls. However, during ambulatory monitoring the duration of transient myocardial ischaemia was significantly reduced in thrombolysed patients: 322 min vs 1144 min in controls (P less than 0.05). Thrombolysed patients reached a higher heart rate during transient ischaemic episodes: 114 +/- 17 vs 93 +/- 11 b.min-1 in controls (P less than 0.001). In conclusion, thrombolytic therapy administered for a first AMI significantly reduces the burden of transient myocardial ischaemia. This may explain the improvement in myocardial function during physical activities, which was also observed in this study.

KW - Coronary Circulation

KW - Coronary Disease

KW - Electrocardiography, Ambulatory

KW - Exercise Test

KW - Hemodynamics

KW - Humans

KW - Infusions, Intravenous

KW - Myocardial Contraction

KW - Myocardial Infarction

KW - Prospective Studies

KW - Retrospective Studies

KW - Thrombolytic Therapy

M3 - Journal article

C2 - 1600986

VL - 13

SP - 484

EP - 490

JO - European Heart Journal

JF - European Heart Journal

SN - 0195-668X

IS - 4

ER -