Serum concentrations of C-reactive protein were studied in 23 patients with acute myocardial infarction. In 14 patients who did not receive thrombolytic treatment there was a linear relation between infarct size (determined by serial creatine kinase-MB determinations and thallium-201 isotope emission tomography) and the C-reactive protein response. The correlation coefficient between the concen...

OBJECTIVES To determine whether patients with acute myocardial infarction undergoing thrombolysis with streptokinase develop changes in renal function. DESIGN Prospective assessment of renal function in 60 consecutive patients admitted with acute myocardial infarction. SETTING Tertiary referral centre and city general hospital. PATIENTS 60 consecutive patients with acute myocardial infarc...

In this study, we examined the effects of various plasminogen activators on arachidonic acid release and prostacyclin biosynthesis in cultured rat aortic smooth muscle cells and bovine pulmonary artery endothelial cells. Prostacyclin was the major product formed from arachidonic acid in aortic smooth muscle cells and endothelial cells. When intact cells were incubated with streptokinase, one of...

BACKGROUND Thrombolytic therapy should only be used when expected benefits outweigh the risks. In order to obtain a precise estimation of prognosis, with and without thrombolytic therapy, we postulated that mortality reduction by thrombolytic therapy is a function of the area of myocardium at risk for necrosis. We developed a model to estimate the myocardial area at risk for necrosis from clini...

Background. Streptokinase reduces the incidence of left ventricular thrombosis after acute myocardial infarction. However, it is unknown whether a similar effect can be obtained with different thrombolytic agents and whether subcutaneous calcium heparin can have an additional efficacy. Methods and Results. To compare the effects of two different thrombolytic agents combined or not with heparin ...

Acute Coronary Syndromes TIMI 14 (Final Results) Presenter: Elliott Antman, MD, Brigham and Women’s Hospital and Harvard Medical School, Boston, Mass. The study: A prospective, multicenter, randomized, controlled trial of combined therapy with thrombolytic agents and the platelet glycoprotein IIb/IIIa antagonist abciximab in patients with AMI. A total of 681 patients were randomized to standard...

Acute Coronary Syndromes TIMI 14 (Final Results) Presenter: Elliott Antman, MD, Brigham and Women’s Hospital and Harvard Medical School, Boston, Mass. The study: A prospective, multicenter, randomized, controlled trial of combined therapy with thrombolytic agents and the platelet glycoprotein IIb/IIIa antagonist abciximab in patients with AMI. A total of 681 patients were randomized to standard...

A serendipitous discovery by William Smith Tillett in 1933, followed by many years of work with his student Sol Sherry, laid a sound foundation for the use of streptokinase as a thrombolytic agent in the treatment of acute myocardial infarction. The drug found initial clinical application in combating fibrinous pleural exudates, hemothorax, and tuberculous meningitis. In 1958, Sherry and others...

Plasminogen is the plasma precursor of the fibrinolytic enzyme, plasmin. The activation of plasminogen isolated from various animal species by streptokinase, a protein of bacterial origin, has received considerable attention in recent years. A two-step reaction has been postulated wherein streptokmase reacts with a substance termed proactivator (1)) which is present in highest concentration in ...

BACKGROUND Changes in platelet aggregation (PA) and platelet surface receptor expression induced by thrombolytic therapy for acute myocardial infarction may influence the rate of initial reperfusion and early reocclusion. METHODS AND RESULTS In the RAPID-1 (Reteplase Angiographic Phase II International Dose-finding study), RAPID-2 (Reteplase vs Alteplase Patency Investigation During myocardia...