Intracoronary Thrombolysis in Evolving Myocardial Infarction (1981)

Editorials1 October 1981Intracoronary Thrombolysis in Evolving Myocardial InfarctionWILLIAM GANZ, M.D.WILLIAM GANZ, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-95-4-500 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptExtensive myocardial necrosis remains the principal cause of death and morbidity among patients hospitalized with acute myocardial infarction. The clinical impact of interventions designed to reduce necrosis by reducing myocardial oxygen demand, augmenting collateral blood supply, or correcting ischemic cellular defects has been disappointing. As a result, the conviction that restoring blood flow to the ischemic myocardium is needed for clinically significant reduction of necrosis is becoming stronger.The rate of myocardial necrosis is known to differ widely in experimental animals, from virtually no necrosis after several hours of coronary artery occlusion to transmural necrosis after only 40 minutes of...References1. BELLER G, HOOD W, and SMITH T. Effects of ischemia and coronary reperfusion on regional myocardial blood flow and on the epicardial electrocardiogram. Cardiovasc Res. 1977;2:489-98. CrossrefGoogle Scholar2. IRVIN R, COBB F, and ROE C. Acute myocardial infarction and MB creatine phosphokinase. Relationship between onset of symptoms of infarction and appearance and disappearance of enzyme. Arch Intern Med. 1980;140:329-34. CrossrefMedlineGoogle Scholar3. REIMER K, LOWE J, RASMUSSEN M, and JENNINGS R. The wavefront phenomenon of ischemic cell death. 1. Myocardial infarct size vs. duration of coronary occlusion in dogs. Circulation. 1977;56:786-94. CrossrefMedlineGoogle Scholar4. RIDOLFI R and HUTCHINS G. The relationship between coronary artery lesions and myocardial infarcts: Ulceration in atherosclerotic plaques precipitating coronary thrombosis. Am Heart J. 1977;93:468-80. CrossrefMedlineGoogle Scholar5. DEWOOD M, SPORES J, NOTSKE R, MOUSER L, BURROUGHS R, and MOHIUDDIN S. Incidence of total coronary occlusion and thrombosis in the early phase of acute transmural myocardial infarction. Clin Res. 1979;27:162. Abstract. Google Scholar6. PHILLIPS S, KONGTAHWORN C, and ZEFF R. Emergency coronary artery revascularization: a possible therapy for acute myocardial infarction. Circulation. 1979;60:241-6. CrossrefMedlineGoogle Scholar7. KANMATSUSE K, LANDO U, MERCIER J, FISHBEIN M, SWAN H, and GANZ W. Rapid lysis of coronary thrombi by local application of fibrinolysin. Circulation. 1979;60 (suppl II):216. Abstract. MedlineGoogle Scholar8. FISHBEIN M, Y-RIT J, LANDO U, KANMATSUSE K, MERCIER J, and GANZ W. The relationship of vascular injury and myocardial hemorrhage to necrosis after reperfusion. Circulation. 1980;62:1274-9. CrossrefMedlineGoogle Scholar9. GANZ W, BUCHBINDER N, and MARCUS H. Intracoronary thrombolysis in evolving myocardial infarction. Am Heart J. 1981;101:4-13. CrossrefMedlineGoogle Scholar10. DHALL D, DAWSON A, and MAVOR G. Problem of resistant thrombolysis and early recurrent thrombosis in streptokinase therapy. Surg Gynecol Obstet. 1978;146:15-20. MedlineGoogle Scholar11. RENTROP P, BLANKE H, KARSCH K, KAISER H, KÖSTERING H, and LEITZ K. Selective intracoronary thrombolysis in acute myocardial infarction and unstable angina pectoris. Circulation. 1981;63:307-17. CrossrefMedlineGoogle Scholar12. MATHEY D, KUCK K, TILSNER V, KREBBER H, and BLEIFELD W. Nonsurgical coronary artery recanalization in acute transmural myocardial infarction. Circulation. 1981;63:489-97. CrossrefMedlineGoogle Scholar13. RENTROP K, BLANKE H, KARSCH K, and KREUZER H. Initial experience with transluminal recanalization of the recently occluded infarct-related coronary artery in acute myocardial infarction—Comparison with conventionally treated patients. Clin Cardiol. 1979;2:92-105. CrossrefMedlineGoogle Scholar14. VATNER S, BAIG H, MANDERS W, and MAROKO P. Effect of coronary artery reperfusion on myocardial infarct size calculated from creatine kinase. J Clin Invest. 1978;61:1048-56. CrossrefMedlineGoogle Scholar15. MADDAHI J, GANZ W, and NINOMIVA K. Myocardial salvage by intracoronary thrombolysis in evolving myocardial infarction: evaluation using intracoronary injection of thallium-201. Am Heart J. 1981;102:664-74. CrossrefMedlineGoogle Scholar16. MIRX W. An analysis of antithrombotic management following coronary artery recanalization in regard to reocclusion rate, reinfarction, hemorrhagic complications and mortality. Am Heart J. In press. Google Scholar17. BRAUNWALD E. Protection of the ischemic myocardium: introductory remarks. Circulation. 1976;53 (Suppl I):1-2. Google Scholar18. GRÜNTZIG A, SENNING A, and SIEGENTHALER W. Nonoperative dilatation of coronary-artery stenosis: percutaneous transluminal coronary angioplasty. N Engl J Med. 1979;301:61-68. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: WILLIAM GANZ, M.D.Affiliations: Division of Cardiology Cedars-Sinai Medical Center University of California School of Medicine Los Angeles; Los Angeles, California PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byReperfusion therapy of acute myocardial infarctionInterventional Therapy for the Treatment of Acute Myocardial Infarction: Thrombolysis with and without AngioplastySuccessful result from delayed streptokinase administration: Subtotal thrombotic occlusion in a subsequently normal coronary arteryPercutaneous transluminal coronary angioplasty: Application for acute myocardial infarctionPercutaneous transluminal coronary angioplasty with and without thrombolytic therapy for treatment of acute myocardial infarctionSecondary Prevention of Coronary Heart DiseaseCorrection: Editorial on Intracoronary Thrombolysis in Infarction 1 October 1981Volume 95, Issue 4Page: 500-502KeywordsAcute myocardial infarctionBloodBlood flowCoronary arteriesMorbidityMyocardial infarctionMyocardiumNecrosisOxygen ePublished: 1 December 2008 Issue Published: 1 October 1981 PDF downloadLoading ...