Prediction of coronary artery reperfusion after tissue plasminogen activator infusion

Catheterization and Cardiovascular Diagnosis
E L Kinney, R J Wright

Abstract

We investigated whether clinical and laboratory variables can predict perfusion status after t-PA administration, by using the data from 138 patients who received t-PA during the Thrombolysis in Myocardial Infarction (TIMI) I study. All clinical and laboratory variables that were collected at baseline or during perfusion for TIMI I were evaluated by the current study. Via stepwise discriminant analysis, 7 variables were closely associated with perfusion status at 90 minutes (listed in the order of their discriminant effect): baseline grade of stenosis in the infarct-related coronary artery, whether nausea was present during the infusion, baseline aspartate aminotransferase (SGOT) concentration, whether arrhythmias were present during the infusion, baseline fibrinogen concentration, baseline partial thromboplastin time, and baseline diastolic blood pressure. Baseline severity of stenosis and the likelihood of there being reperfusion were inversely related. Eighty-four percent of patients with adequate perfusion after 90 minutes of t-PA infusion were classified correctly, but only 50% of those without perfusion at 90 minutes were classified correctly. In addition, since 70% of the TIMI I patients, on average, did achieve perfusio...Continue Reading

References

Dec 1, 1988·Journal of the American College of Cardiology·E J TopolK L Lee
Apr 1, 1988·Journal of the American College of Cardiology·R W BrowerM Verstraete
Nov 1, 1986·American Heart Journal·F C MillerC E Rackley
Apr 4, 1985·The New England Journal of Medicine·UNKNOWN TIMI Study Group

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