engleski

Electrocardiographic and enzymatic estimation of acute myocardial infarct size in the evaluation of therapeutic success after thrombolytic treatment

Aim was to evaluate whether electrocardiographic and enzymatic estimation of infarct size can give evidence of myocardial salvage after thrombolytic treatment. One hundred eighty-three patients treated with streptokinase within 6 hours from acute myocardial infarction (AMI) onset entered the study. The expected AMI size was calculated from the admission ECG by previously developed formulas based on initial ST segment elevation. The final AMI size was determined from the Selvester QRS score on the predischarge ECG. The percentage of difference in AMI size (Δ AMI) provided a quantitative measure of myocardial salvage. The enzymatic estimation of AMI size was done by integration of the creatine kinase (CK) time-activity curve. The cumulative CK in blood (Co) and percentage of AMI (%AMI) were calculated. In 116 patients with sustained reperfusion (63%) Δ AMI was -37%, while in 54 patients without reperfusion (30%) it was +19% (p<0.001). Enzymatic estimation of AMI size also showed lower values of Co (2586 vs. 3821 IU/L, p<0.01) and % of AMI (11% vs. 16%, p<0.01) in these patients. It seems that ECG and enzymatic measurements can provide semiquantitative estimate of myocardial salvage in AMI after thrombolytic treatment.

ECG ; enzymes ; myocardial infarction ; thrombolysis

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