PMID- 25746841
OWN - NLM
STAT- MEDLINE
DCOM- 20150928
LR  - 20181113
IS  - 1643-3750 (Electronic)
IS  - 1234-1010 (Print)
IS  - 1234-1010 (Linking)
VI  - 21
DP  - 2015 Mar 8
TI  - The relationship between grade of ischemia, success of reperfusion, and type of 
      thrombolytic regimen.
PG  - 716-21
LID - 10.12659/MSM.892645 [doi]
AB  - BACKGROUND: This study was aimed to determine whether the grade of ischemia can 
      predict the success of reperfusion in patients treated with thrombolytic therapy 
      (TT) for ST elevation myocardial infarction (STEMI). MATERIAL AND METHODS: We 
      enrolled 229 consecutive patients with diagnosis of STEMI and receiving TT. 
      Patients were divided into 2 groups--grade 2 ischemia (GI2) and grade 3 ischemia 
      (GI3)--according to initial electrocardiogram (ECG). As TT, fibrin-specific 
      (tissue plasminogen activator (t-PA)) or non-fibrin-specific (streptokinase 
      (SKZ)) regimens were used. Successful reperfusion was defined as >50% resolution 
      of the maximal ST segment on 90-min ECG. We tried to evaluate whether the grade 
      of ischemia could predict the success of reperfusion and if there were any 
      differences in terms of successful reperfusion between different thrombolytic 
      regimens. RESULTS: The successful reperfusion rate was significantly higher in 
      GI2 than GI3 (82.4% vs. 64.4% respectively, p=0.002). The success rate was lowest 
      at anterior GI3 (55.8%). Although there was no significant difference between 
      thrombolytic regimens in all groups (p=0.77), t-Pa was superior to SKZ in 
      anterior GI3 (63,6% vs. 30%, p=0.061). In addition, in multivariate analysis, GI 
      and infarct localization were found as independent predictors for successful 
      reperfusion with TT (p=0.006 and p=0.042, respectively). CONCLUSIONS: In the 
      current study, we found that GI2 is an independent predictor for successful 
      reperfusion in STEMI treated with TT. Fibrin specific regime should be preferred 
      in anterior GI3.
FAU - Ayca, Burak
AU  - Ayca B
AD  - Department of Cardiology, Bagcilar Education and Research Hospital, Bagcilar, 
      Istanbul, Turkey.
FAU - Conkbayir, Cenk
AU  - Conkbayir C
AD  - Department of Cardiology, Near East University, Nicosia, Cyprus.
FAU - Katkat, Fahrettin
AU  - Katkat F
AD  - Department of Cardiology, Istanbul University, Cardiology Institution, Haseki, 
      Istanbul, Turkey.
FAU - Gulsen, Kamil
AU  - Gulsen K
AD  - Department of Cardiology, Near East University, Nicosia, Cyprus.
FAU - Akin, Fatih
AU  - Akin F
AD  - Department of Cardiology, Sitki Kocman University, Mugla, Turkey.
FAU - Okuyan, Ertugrul
AU  - Okuyan E
AD  - Department of Cardiology, Bagcilar Education and Research Hospital, Bagcilar, 
      Istanbul, Turkey.
FAU - Baskurt, Murat
AU  - Baskurt M
AD  - Department of Cardiology, Istanbul University, Cardiology Institution, Haseki, 
      Istanbul, Turkey.
FAU - Okcun, Baris
AU  - Okcun B
AD  - Department of Cardiology, Near East University, Nicosia, Cyprus.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20150308
PL  - United States
TA  - Med Sci Monit
JT  - Medical science monitor : international medical journal of experimental and 
      clinical research
JID - 9609063
SB  - IM
MH  - Electrocardiography
MH  - Female
MH  - Humans
MH  - Male
MH  - Multivariate Analysis
MH  - Myocardial Infarction/diagnostic imaging/pathology
MH  - Myocardial Ischemia/diagnostic imaging/*pathology/*therapy
MH  - *Myocardial Reperfusion
MH  - *Thrombolytic Therapy
MH  - Treatment Outcome
MH  - Ultrasonography
PMC - PMC4362488
EDAT- 2015/03/10 06:00
MHDA- 2015/09/29 06:00
PMCR- 2015/03/08
CRDT- 2015/03/10 06:00
PHST- 2015/03/10 06:00 [entrez]
PHST- 2015/03/10 06:00 [pubmed]
PHST- 2015/09/29 06:00 [medline]
PHST- 2015/03/08 00:00 [pmc-release]
AID - 892645 [pii]
AID - 10.12659/MSM.892645 [doi]
PST - epublish
SO  - Med Sci Monit. 2015 Mar 8;21:716-21. doi: 10.12659/MSM.892645.