Late Thrombolytic Therapy in Acute Myocardial Infarction

60 patients admitted to Gazi University Faculty of Medicine with the diagnosis of acute myocardial infarction in the first 24 hours following the onset of symptoms have been evaluated. 26 of these patients who were admitted within 6 hours of pain and were treated with intravenous streptokinase were called the early treatment group. 16 patients admitted within 6-24 hours after pain were also treated with intravenous streptokinase and they made up the late treatment group. The control group consisted of 18 patients who were admitted within 6-24 hours after the beginning of pain and were not treated with thrombolytic agents. All patients received 500 mg aspirin and 1000 U/hour heparin within the first 24 hours. Coronary angiograms of all patients were performed in the first week of admission and were evaluated by a single cardiologist in a blind manner-according to TIMI classification of flow in the infarct-related artery (IRA). 21 of the 26 patients in the early treatment group (80.8%) and 10 of the 16 patients in the late treatment group (62.5%) had a TIMI 3 flow in their IRA. The difference between the two groups was statistically not significant (p>0.05). Only 3 of the 18 patients in the control group had a TIMI 3 flow in their IRA (16.7%). The difference between the control group and either treatment group was statistically significant (p<0.001, p<0.01). Infarct related wall motion abnormality of left ventricle was observed in 92% of the early treatment group, 75% of the late treatment group and 83% of the control group, the difference between groups being not significant (p>0.05).