scholarly journals Relationship between QT dispersion and reperfusion in the acute myocardial infarction

2003 ◽  
Vol 60 (1) ◽  
pp. 19-27 ◽  
Author(s):  
Branko Gligic ◽  
Radoslav Romanovic ◽  
Goran Radjen ◽  
Dragan Tavciovski ◽  
Predrag Djuran ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Thrombolytic Therapy ◽  
Qt Dispersion ◽  
The Other ◽  
Significant Difference ◽  
The Difference

Background. QT dispersion (QTd) represents the parameter of the expanded heterogeneity of myocard of ventricles. The aim of this study was to examine the dynamics of changes of QTd during the first 5 days of the acute myocardial infarction (AMI) in dependence to noninvasively estimated success of thrombolytic therapy. Methods. Thirty six patients with AMI were included in the study. All patients were treated with alteplaze according to rapid protocol. QTd (QTc max-QTc min) was measured immediately after the reception (0 min), after the thrombolytic therapy (90 min) and since the 2nd to the 5th day of the hospitalization. Reperfusion was estimated on the basis of electrocardiographic and biohumoral parameters. Results. In the group of 36 patients, 22 male and 11 female, both parameters of the reperfusion were not compatible in 3 patients. The other 23 patients had the reperfusion, while 10 patients did not have it. At the reception there was no significant difference of QTd between the group with reperfusion (79?34 ms) and the group without reperfusion (65?19 ms). After receiving alteplase, the average QTd in the group with reperfusion was 67?31 ms, which was not shorter in relation to the group without reperfusion (70?23 ms). Since the 2nd day of AMI, significantly smaller QTd in patients with reperfusion was not registered compared with the patients without the reperfusion (54?17 vs.73?20 ms), whereas since the 3rd day the difference became significant (46?16 vs. 87?24 ms). On the 4th day it was 43?12 vs. 78?21 ms, and on the 5th day it was 38?11 vs. 62?23 ms. On the 1st day significant difference of QTd between the groups with and without reperfusion was not registered in the group of patients with anterior AMI (0 min: 97?47 vs. 72?16; 90 min 68?47 vs. 72?20) whereas on the 2nd day it became statistically significant (51?15 vs. 74?20 on the 2nd day, 51?20 vs. 88?24 on the 3rd day, 46?10 vs. 81?19 on the 4th day and 40?8 vs. 69?22 ms on the 5th day. In the group of patients with inferolateral AMI, only on the 3rd day significant difference of QTd between the group with and the group without reperfusion was registered (43?14 vs. 69?29 ms), while in all other measuring it was not registered (0 min: 69?22 vs. 42?9; 90 min: 67?20 vs. 67?41; 55?19 vs. 60?25 on the 2nd day; 41?14 vs. 51?6 on the 4th day and 51?12 vs. 37?8 ms on the 5th day). Conclusion. Qt dispersion was of significantly shorter duration in patients with the successfully performed reperfusion in relation to the patients without the reperfusion. In patients with the anterior AMI, QTd was significantly different in patients with in relation to the patients without the reperfusion in distinction with the patients with inferolateral AMI.

Effect of Thrombolytic Therapy on QT Dispersion in Elderly Versus Younger Patients With Acute Myocardial Infarction

2003 ◽  
Vol 10 (1) ◽  
pp. 7-11 ◽  
Author(s):  
Nirav J. Mehta ◽  
Ijaz A. Khan ◽  
Rajal N. Mehta ◽  
Bienvenido Burgonio ◽  
Gaurav Lakhanpal
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Thrombolytic Therapy ◽  
Qt Dispersion ◽  
Younger Patients

scholarly journals Comparative assessment of the indices of the left ventricle post-infarction remodelling of the left ventricle and its dependence on the strategy of acute myocardial infarction management

2013 ◽  
Vol 20 (3) ◽  
pp. 75-78
Author(s):  
D. M. Zhidovich ◽  
L. V. Shcheglova
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Left Ventricle ◽  
Thrombolytic Therapy ◽  
Comparative Assessment ◽  
Dynamic Monitoring ◽  
Sphericity Index ◽  
Significant Difference ◽  
Group Ii ◽  
Left Ventricle Remodelling

Comparative assessment of the indices of post-infarction remodelling of the left ventricle was carried out in the patients with myocardium reperfusion (thrombolytic therapy) and without reperfusion. ECG was performed for all patients on admission to the hospital and then 3 and 6 months later. The results obtained demonstrated that after the acute period of myocardial infarction there was no difference between the parameters under control. At the same time the results of dynamic monitoring confirmed that later on the patients felt some peculiarities during the left ventricle remodelling process. Three months later there was an increase of the left ventricle sphericity index during the systoly in the patients of group II. Six months later the patients of group II showed significant difference in five indices of remodelling versus the patients on thrombolitic therapy.

The Relation Between Platelet Reactivity and Coronary Angiographic Findings in Young Female Survivors of Acute Myocardial Infarction

1986 ◽  
Vol 56 (02) ◽  
pp. 207-210
Author(s):  
Jack Kutti ◽  
Hans Wadenvik ◽  
Saga Johansson ◽  
Lars Vilén ◽  
Anders Vedin ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Matched Control ◽  
Platelet Reactivity ◽  
Young Female ◽  
Female Survivors ◽  
Significant Difference ◽  
The Difference ◽  
Significant Coronary Stenosis ◽  
Angiographic Findings

SummaryIn 31 women who had survived their first acute myocardial infarction (MI) studies of platelet reactivity were related to coronary angiographic findings. The results were compared to those obtained from 38 age-matched control women. According to the cardioangiographic findings the group of MI was subdivided into: 9 patients with 1-vessel disease (VD), 10 patients with 2-VD, and 5 patients with 3-VD; 7 subjects did not reveal significant coronary stenosis. When each of these 4 subgroups of MI-patients were compared with the control material significant difference with respect to PF4 was found only for subjects with 1-VD (20.0 ± 4.8 vs. 10.3 ± 0.6 ng/ml). As regards BTG the difference was significant for 1-VD and 2-VD patients (69 ± 12 and 59 ± 3, respectively vs. 40 ± 2 ng/ml). The cumulative frequency for secondary aggregation differed only as regards 1-VD patients (78 vs 40%).

scholarly journals Delay factors on the administration of thrombolytic therapy in patients diagnosed with acute myocardial infarction in a general hospital

2008 ◽  
Vol 16 (1) ◽  
pp. 52-56 ◽  
Author(s):  
Luis Antônio Muller ◽  
Eneida Rejane Rabelo ◽  
Maria Antonieta Moraes ◽  
Karina Azzolin
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Thrombolytic Therapy ◽  
Medical Records ◽  
Medical Service ◽  
Time Of Arrival ◽  
Thrombolytic Treatment ◽  
Study Results ◽  
Significant Difference ◽  
Long Time

OBJECTIVE: To identify factors that delay the onset of thrombolysis in patients with acute myocardial infarction (AMI). METHODS: A cohort study was carried out with 146 patients, each diagnosed with AMI and subjected to thrombolytic therapy. The data was extracted from medical records between January 2002 and December 2004. RESULTS: The average age of the studied population was 57.5 ± 9 years, 64.4% were male. The average time between the onset of pain and arrival at the hospital was 254.7 ± 126.6 minutes, 28.1% used an ambulance for the trip to the hospital, the door-to-electrocardiogram time averaged 19.4 ± 7.3 minutes and the door-to-needle time was 51.1 ± 14.9 minutes. There was no significant difference between the time of arrival to the hospital and the method of transportation used (P= 0.81), and those seen by cardiologists and during the nightshift had a reduction in the door-to-needle time, respectively (P=0.014) and (P=0.034). CONCLUSIONS: Study results show that the delay in the search for medical service, and the long time taken from door-to-electrocardiogram and to reach the AMI diagnosis were the factors involved in the delay of thrombolytic treatment.

The safety of automatic versus manual blood pressure cuffs for patients receiving thrombolytic therapy

1998 ◽  
Vol 7 (3) ◽  
pp. 192-196 ◽  
Author(s):  
L Saul ◽  
J Smith ◽  
W Mook
Keyword(s):  
Myocardial Infarction ◽  
Blood Pressure ◽  
Acute Myocardial Infarction ◽  
Thrombolytic Therapy ◽  
Case Reports ◽  
Significant Difference ◽  
Increase Risk ◽  
Automatic Blood Pressure ◽  
Research Findings ◽  
Manual Blood Pressure

BACKGROUND: Patients receiving thrombolytic therapy for acute myocardial infarction require frequent monitoring of blood pressure. Historically, many nurses have been reluctant to use automatic blood pressure cuffs during thrombolytic therapy because of concern that the automatic cuffs might increase risk of bleeding. This concern is not based on research findings but on case reports, anecdotal observations, and possible myths in clinical practice. OBJECTIVE: To determine the safety of using automatic blood pressure cuffs during thrombolytic therapy in patients with acute myocardial infarction. METHODS: Ninety-six patients with acute myocardial infarction who received thrombolytic therapy (streptokinase or tissue plasminogen activator) were randomized to have blood pressure measurements obtained with either automatic or manual blood pressure cuffs. Patients were checked at least every 2 hours for purpuric lesions (petechiae, ecchymoses, or hematomas). The study ended after 24 hours of measurements or when a purpuric lesion was noted. RESULTS: We found no significant difference in frequency of purpuric lesions between patients who had blood pressure measured with a manual cuff and patients who had blood pressure measured with an automatic cuff. The most common purpuric lesions noted were ecchymoses. A significant difference was noted in the frequency of purpuric lesions depending on which thrombolytic agent was used, regardless of cuff type. CONCLUSIONS: Automatic blood pressure cuffs are as safe as manual blood pressure cuffs in patients with acute myocardial infarction who are receiving thrombolytic therapy.

Thrombolytic Therapy: A Review of Its Use in Acute Myocardial Infarction

1998 ◽  
Vol 32 (7-8) ◽  
pp. 769-784 ◽  
Author(s):  
Eric D Bizjak ◽  
Vincent F Mauro
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Clinical Trials ◽  
Thrombolytic Therapy ◽  
Thrombolytic Agent ◽  
Clinical Investigation ◽  
Survival Rates ◽  
Thrombolytic Agents ◽  
Significant Difference ◽  
To Receive

OBJECTIVE: To review the literature on the use of thrombolytic agents in the pharmacotherapeutic management of acute myocardial infarction (AMI). DATA SOURCE: English-language clinical trials, reviews, and editorials derived from MEDLINE (January 1966–September 1997) and/or cross-referencing of selected articles. STUDY SELECTION: Articles that were selected best represent the clinical trials researching the role for thrombolytics in the therapy of AMI to improve morbidity and mortality. DATA SYNTHESIS: AMI is one of the leading causes of mortality in the US. Following supportive data that the most common cause of an AMI is an intracoronary thrombus, clinical investigation has demonstrated that intravenous thrombolytic agents improve survival rates in patients who experience an AMI. Several clinical trials have been conducted to determine whether one thrombolytic agent is superior to others with respect to improving mortality. At present, only the first Global Use of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries (GUSTO-I) trial has reported any statistically significant difference in mortality rate. In this trial, “front-loaded” alteplase induced a statistically significant (p < 0.001) 1% absolute reduction in 30-day and 1-year mortality compared with streptokinase. This has led to alteplase being the preferred thrombolytic at many US institutions. However, the results of GUSTO-I have been questioned by some on the basis of either study design or clinical significance. CONCLUSIONS: Thrombolytic agents have secured a place in the treatment of AMI due to their well-proven reduction in mortality rates. In general, comparative trials have demonstrated minimal differences in efficacy among these agents. Probably just as important as choosing which thrombolytic agent to use is ensuring that a patient experiencing an AMI is administered thrombolytic therapy unless a contraindication to receive such therapy exists in the patient and/or the patient is a candidate to receive an emergent intracoronary procedure. Trials also indicate that the sooner thrombolytics can be administered, the greater the benefit to the patient.

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