This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Tendera, M. P. Articles by Ray, W. A. Search for Related Content PubMed PubMed Citation Articles by Tendera, M. P. Articles by Ray, W. A.

Circulation, Vol 71, 124-128, Copyright © 1985 by American Heart Association

ARTICLES

Factors influencing probability of reperfusion with intracoronary ostial infusion of thrombolytic agent in patients with acute myocardial infarction

MP Tendera, WB Campbell, SN Tennant and WA Ray

A multivariate logistic regression equation was used to evaluate variables related to successful intracoronary thrombolytic therapy. One hundred seventeen patients with a totally occluded infarct-related artery were randomly given ostial infusions of urokinase or streptokinase in a blinded study. The opening rate was 57%. The agent used and time from onset of symptoms to beginning of treatment did not significantly influence opening rate (p greater than .25). The site of occlusion was a strong predictor of opening rate (p = .0004). The anterior descending coronary artery was successfully opened more frequently than the left circumflex or right coronary artery (p = .012). Presence of collaterals adversely affected the recanalization rate in all groups (p = .0004). These variables had an additive effect on the probability of opening. Patients with proximal anterior descending occlusion and no collaterals had a 90% recanalization rate, while those with distal occlusions in vessels other than the anterior descending and with collaterals had only a 24% chance for reperfusion. Thus location of occlusion and presence or absence of collaterals may strongly influence opening rates.

This article has been cited by other articles:

				C. F. Lundergan, J. S. Reiner, W. F. McCarthy, K. S. Coyne, R. M. Califf, A. M. Ross, and for the GUSTO-I Angiographic Investigators Clinical predictors of early infarct-related artery patency following thrombolytic therapy: importance of body weight, smoking history, infarct-related artery and choice of thrombolytic regimen: the GUSTO-I experience J. Am. Coll. Cardiol., September 1, 1998; 32(3): 641 - 647. [Abstract] [Full Text] [PDF]

				L. Chouhan, H. A. Hajar, T. George, and J. C. Pomposiello Clinical and Angiographic Features of Patients with an Occluded Versus a Patent Infarct Vessel After Intravenous Streptokinase for Acute Myocardial Infarction Angiology, June 1, 1993; 44(6): 425 - 431. [Abstract] [PDF]

				Thrombolysis for Evolving Myocardial Infarction Ann Intern Med, September 1, 1985; 103(3): 463 - 469. [Abstract] [PDF]