Improvement of regional myocardial metabolism after coronary thrombolysis induced with tissue-type plasminogen activator or streptokinase

B. E. Sobel, E. M. Geltman, A. J. Tiefenbrunn, A. S. Jaffe, J. J. Spadaro, M. M. Ter-Pogossian, D. Collen, P. A. Ludbrook

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Abstract

To assess the effects on the heat itself of coronary thrombolysis induced with either tissue-type plasminogen activator (t-PA) or streptokinase (SK), we performed positron emission tomography with 11C-palmitate in 19 patients with initial transmural myocardial infarction immediately after admission and again within 48 to 72 hr after intracoronary administration of t-PA (n = 2) or SK (n = 17). Clots were persistent in eight patients treated with SK despite an average dose of 336,000 IU, sufficient to markedly deplete fibrinogen. In the absence of lysis, favorable tomographic changes did not occur. In contrast, in each of the 11 patients in whom lysis was induced (two with t-PA and nine with SK) myocardial accumulation of 11C-palmitate improved by an average of 29% in the late compared with early studies (p <0.001). Results were comparable in patients with anterior and those with inferior infarction. Thus clot lysis induced with either t-PA or SK led to improved regional myocardial metabolism.

Original languageEnglish (US)
Pages (from-to)983-990
Number of pages8
JournalCirculation
Volume69
Issue number5
DOIs
StatePublished - Jan 1 1984

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Sobel, B. E., Geltman, E. M., Tiefenbrunn, A. J., Jaffe, A. S., Spadaro, J. J., Ter-Pogossian, M. M., Collen, D., & Ludbrook, P. A. (1984). Improvement of regional myocardial metabolism after coronary thrombolysis induced with tissue-type plasminogen activator or streptokinase. Circulation, 69(5), 983-990. https://doi.org/10.1161/01.CIR.69.5.983