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Titolo:
EFFECTS OF THROMBOLYTIC THERAPY ADMINISTERED 6 TO 24 HOURS AFTER MYOCARDIAL-INFARCTION ON THE SIGNAL-AVERAGED ECG - RESULTS OF A MULTICENTER RANDOMIZED TRIAL
Autore:
STEINBERG JS; HOCHMAN JS; MORGAN CD; DORIAN P; NAYLOR CD; THEROUX P; TOPOL EJ; ARMSTRONG PW;
Indirizzi:
ST LUKES ROOSEVELT HOSP,DIV CARDIOL,1111 AMSTERDAM AVE NEW YORK NY 10025 COLUMBIA UNIV,COLL PHYS & SURG NEW YORK NY 00000 UNIV TORONTO TORONTO ON CANADA MONTREAL HEART INST MONTREAL H1T 1C8 PQ CANADA CLEVELAND CLIN FDN CLEVELAND OH 44195
Titolo Testata:
Circulation
fascicolo: 2, volume: 90, anno: 1994,
pagine: 746 - 752
SICI:
0009-7322(1994)90:2<746:EOTTA6>2.0.ZU;2-6
Fonte:
ISI
Lingua:
ENG
Soggetto:
VENTRICULAR LATE POTENTIALS; REPERFUSION THERAPY; ARRHYTHMIC EVENTS; CORONARY-ARTERY; PROGNOSTIC-SIGNIFICANCE; CLINICAL-VARIABLES; ELECTROCARDIOGRAM; REDUCTION; PATENCY; FIBRILLATION;
Keywords:
THROMBOLYSIS; REPERFUSION; DEATH, SUDDEN; ELECTROCARDIOGRAPHY; MYOCARDIAL INFARCTION; ARRHYTHMIA;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
41
Recensione:
Indirizzi per estratti:
Citazione:
J.S. Steinberg et al., "EFFECTS OF THROMBOLYTIC THERAPY ADMINISTERED 6 TO 24 HOURS AFTER MYOCARDIAL-INFARCTION ON THE SIGNAL-AVERAGED ECG - RESULTS OF A MULTICENTER RANDOMIZED TRIAL", Circulation, 90(2), 1994, pp. 746-752

Abstract

Background Thrombolytic therapy reduces mortality after acute myocardial infarction, even when treatment is initiated relatively late afteronset of symptoms. The mechanism underlying this survival benefit is incompletely understood. Methods and Results In a prospectively designed ancillary study of a randomized, placebo-controlled trial of late thrombolytic therapy (LATE), the signal-averaged (SA) ECG was recorded before hospital discharge in an effort to assess the effect of thrombolytic therapy on arrhythmia substrate. Three hundred ten patients wereenrolled at 23 participating sites; 160 patients received placebo, and 150 patients received recombinant tissue-type plasminogen activator (rTPA) therapy 6 to 24 hours after onset of symptoms. Compared with placebo, rTPA tended to reduce the frequency of SAECG abnormality (filtered QRS duration >120 milliseconds) by 37% (95% CI, -64%, +6%; P=.087)and the filtered QRS duration (105.7+/-13.8 versus 108.8+/-14.6 milliseconds, P=.05). In the prespecified subgroup of 185 patients with ST elevation on the qualifying ECG, rTPA resulted in a 52% reduction (95%CI, 4% to 77%, P=.011) of SAECG abnormality and a shorter filtered QRS duration (105.7+/-10.9 versus 110.7+/-15.9 milliseconds, P=.01). No benefit was seen in patients without ST elevation on ECG. Conclusions Late thrombolytic therapy produced a more stable electrical substrate,which probably represents an important mechanism of mortality benefit.

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Documento generato il 14/07/20 alle ore 06:19:57