Ischemic cerebral infarction after rt-PA and heparin therapy for acute myocardial infarction. The TIMI-II pilot and randomized clinical trial combined experience

Stroke; a Journal of Cerebral Circulation
M SloanE Braunwald

Abstract

Ischemic cerebral infarction (CI) is a serious complication of acute myocardial infarction (MI). Little information exists on CI after thrombolytic therapy for MI. Of 3924 MI patients treated with recombinant tissue plasminogen activator (rt-PA) and heparin, 29 (0.7%) developed CI after treatment. All CI patients had detailed neurological evaluations, and 27 (93%) had CT scans centrally reviewed. Age range was 40 to 74 years (mean, 60 years); 25 patients (86%) were men, and 22 (76%) were white. The electrocardiographic location of MI was anterior in 22 (76%) and nonanterior in 7 (24%). Five CIs occurred within 6 hours, 4 between 6 to 24 hours, 8 during the remainder of the first week, 10 during the second week, and 2 others distributed over the 4 weeks after study entry. Six of 29 CIs did not involve the cerebral cortex; 9 patients (31%) had multiple CIs. Of 28 CIs thought to be embolic in origin, 17 showed strong evidence for at least one cardiac abnormality (mural clot, wall-motion abnormality, aneurysm, or atrial fibrillation) known to be associated more specifically with embolism than MI. Eight of 27 CIs (30%) with CT scans had hemorrhagic transformation of varying degrees; 5 were symptomatic. The time of occurrence and sit...Continue Reading

References

Apr 27, 1979·Cardiovascular Radiology·D F Adams, H L Abrams
Aug 12, 1978·British Medical Journal·P L Thompson, J S Robinson
Nov 25, 1989·BMJ : British Medical Journal·P J StaffordD A Chamberlain
Nov 16, 1985·British Medical Journal·P J ShawD A Shaw
May 1, 1988·Annals of Internal Medicine·R E CranstonA Barreuther
Sep 1, 1986·Archives of Neurology·C R GrossS Calingo
Dec 1, 1985·The Annals of Thoracic Surgery·T J GardnerB A Reitz
Jun 1, 1985·The American Journal of Cardiology·J E NordrehaugG von der Lippe
Nov 1, 1984·Neurology·M S KomradR M Califf
May 1, 1984·British Heart Journal·K A JohannessenG von der Lippe
Sep 1, 1980·Annals of Surgery·W D TurnipseedF O Belzer
Nov 1, 1994·Journal of the American College of Cardiology·S C HeikC Chen
Oct 1, 1994·Neurology·H S JørgensenT S Olsen
Jul 1, 1994·Journal of the American College of Cardiology·M M BodenheimerA J Moss
Nov 15, 1993·The American Journal of Cardiology·D L Brown, E J Topol
Jul 1, 1993·Neurology·M S PessinL R Caplan
Mar 1, 1993·Neurology·B TettenbornT R Price

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Citations

Sep 10, 2010·The American Journal of Emergency Medicine·Adel M Hasanin, Abdulhalim J Kinsara
Dec 27, 2008·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Gul Yalcin-CakmakliTurgay Dalkara
Aug 9, 2011·Stroke Research and Treatment·M Àngels FontAdrià Arboix
Jan 6, 2005·American Heart Journal·Michael A Sloan
Aug 28, 2003·The Annals of Otology, Rhinology, and Laryngology·Renzo MoraT J Yoo
Nov 20, 1998·Chest·J A CairnsV Fuster

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