PMID: 9436073Jan 22, 1998Paper

Comparison of effects of thrombolytic therapy followed by elective coronary intervention and direct coronary intervention in acute myocardial infarction: usefulness of dobutamine stress echocardiography

Journal of cardiology
K HasegawaH Hishida

Abstract

The effects of intravenous administration of tissue plasminogen activator (t-PA) followed by elective percutaneous transluminal coronary angioplasty (PTCA) were compared to those of direct PTCA (d-PTCA) in patients with acute myocardial infarction using dobutamine stress echocardiography 1 week and 1 month after the acute episode. There were 12 patients in the t-PA group and nine patients in the d-PTCA group. Dobutamine was infused at incremental doses (5 micrograms/kg/min for each 5 min step). Wall motion changes were classified during infusion into four patterns, improvement, biphasic, worsening and no change. One week after the acute episode, seven of 12 patients in the t-PA group showed biphasic the pattern and five showed the improvement pattern. The biphasic pattern was observed in three patients in the d-PTCA group, worsening in one and improvement in five. One month later, the biphasic pattern in five patients in the t-PA group changed to the improvement pattern. No patients in the d-PTCA group showed changes in the wall motion pattern. There was no difference between the two groups in the frequency of the change of wall motion patterns 1 week and 1 month after infarction, but the improvement pattern was significantly i...Continue Reading

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