Comparison of effects of thrombolytic therapy followed by elective coronary intervention and direct coronary intervention in acute myocardial infarction

Usefulness of dobutamine stress echocardiography

K. Hasegawa, M. Iwase, H. Matsuyama, M. Kimura, S. Koie, C. Kato, H. Yamamoto, A. Hatada, Junichi Ishii, M. Nomura, Y. Watanabe, H. Hishida

Research output: Contribution to journalArticle

Abstract

The effects of intravenous administration of tissue plasminogen activator (t-PA) followed by elective percutaneous transluminal coronary angioplasty (PTCA) were compared to those of direct PTCA (d-PTCA) in patients with acute myocardial infarction using dobutamine stress echocardiography 1 week and 1 month after the acute episode. There were 12 patients in the t-PA group and nine patients in the d-PTCA group. Dobutamine was infused at incremental doses (5 μg/kg/min for each 5 min step). Wall motion changes were classified during infusion into four patterns, improvement, biphasic, worsening and no change. One week after the acute episode, seven of 12 patients in the t-PA group showed biphasic the pattern and five showed the improvement pattern. The biphasic pattern was observed in three patients in the d-PTCA group, worsening in one and improvement in five. One month later, the biphasic pattern in five patients in the t-PA group changed to the improvement pattern. No patients in the d-PTCA group showed changes in the wall motion pattern. There was no difference between the two groups in the frequency of the change of wall motion patterns I week and I month after infarction, but the improvement pattern was significantly increased from five to 10 patients in the t-PA group after 1 month (p<0.05). The sensitivity, specificity and accuracy of the biphasic pattern in the t-PA group for indicating remnant coronary stenosis were 78%, 100% and 83%, respectively. Evaluation of wall motion pattern by dobutamine stress echocardiography is useful for assessment of reperfusion therapy for acute myocardial infarction. The administration of t-PA followed by elective PTCA has similar efficacy to d-PTCA.

Original languageEnglish
Pages (from-to)313-320
Number of pages8
JournalJournal of cardiology
Volume30
Issue number6
Publication statusPublished - 01-12-1997

Fingerprint

Stress Echocardiography
Thrombolytic Therapy
Tissue Plasminogen Activator
Myocardial Infarction
Coronary Balloon Angioplasty
Dobutamine
Coronary Stenosis
Intravenous Administration
Infarction
Reperfusion
Sensitivity and Specificity

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Hasegawa, K. ; Iwase, M. ; Matsuyama, H. ; Kimura, M. ; Koie, S. ; Kato, C. ; Yamamoto, H. ; Hatada, A. ; Ishii, Junichi ; Nomura, M. ; Watanabe, Y. ; Hishida, H. / Comparison of effects of thrombolytic therapy followed by elective coronary intervention and direct coronary intervention in acute myocardial infarction : Usefulness of dobutamine stress echocardiography. In: Journal of cardiology. 1997 ; Vol. 30, No. 6. pp. 313-320.
@article{5a4a6189eda547a29bb219296f9a032e,
title = "Comparison of effects of thrombolytic therapy followed by elective coronary intervention and direct coronary intervention in acute myocardial infarction: Usefulness of dobutamine stress echocardiography",
abstract = "The effects of intravenous administration of tissue plasminogen activator (t-PA) followed by elective percutaneous transluminal coronary angioplasty (PTCA) were compared to those of direct PTCA (d-PTCA) in patients with acute myocardial infarction using dobutamine stress echocardiography 1 week and 1 month after the acute episode. There were 12 patients in the t-PA group and nine patients in the d-PTCA group. Dobutamine was infused at incremental doses (5 μg/kg/min for each 5 min step). Wall motion changes were classified during infusion into four patterns, improvement, biphasic, worsening and no change. One week after the acute episode, seven of 12 patients in the t-PA group showed biphasic the pattern and five showed the improvement pattern. The biphasic pattern was observed in three patients in the d-PTCA group, worsening in one and improvement in five. One month later, the biphasic pattern in five patients in the t-PA group changed to the improvement pattern. No patients in the d-PTCA group showed changes in the wall motion pattern. There was no difference between the two groups in the frequency of the change of wall motion patterns I week and I month after infarction, but the improvement pattern was significantly increased from five to 10 patients in the t-PA group after 1 month (p<0.05). The sensitivity, specificity and accuracy of the biphasic pattern in the t-PA group for indicating remnant coronary stenosis were 78{\%}, 100{\%} and 83{\%}, respectively. Evaluation of wall motion pattern by dobutamine stress echocardiography is useful for assessment of reperfusion therapy for acute myocardial infarction. The administration of t-PA followed by elective PTCA has similar efficacy to d-PTCA.",
author = "K. Hasegawa and M. Iwase and H. Matsuyama and M. Kimura and S. Koie and C. Kato and H. Yamamoto and A. Hatada and Junichi Ishii and M. Nomura and Y. Watanabe and H. Hishida",
year = "1997",
month = "12",
day = "1",
language = "English",
volume = "30",
pages = "313--320",
journal = "Journal of Cardiology",
issn = "0914-5087",
number = "6",

}

Hasegawa, K, Iwase, M, Matsuyama, H, Kimura, M, Koie, S, Kato, C, Yamamoto, H, Hatada, A, Ishii, J, Nomura, M, Watanabe, Y & Hishida, H 1997, 'Comparison of effects of thrombolytic therapy followed by elective coronary intervention and direct coronary intervention in acute myocardial infarction: Usefulness of dobutamine stress echocardiography', Journal of cardiology, vol. 30, no. 6, pp. 313-320.

Comparison of effects of thrombolytic therapy followed by elective coronary intervention and direct coronary intervention in acute myocardial infarction : Usefulness of dobutamine stress echocardiography. / Hasegawa, K.; Iwase, M.; Matsuyama, H.; Kimura, M.; Koie, S.; Kato, C.; Yamamoto, H.; Hatada, A.; Ishii, Junichi; Nomura, M.; Watanabe, Y.; Hishida, H.

In: Journal of cardiology, Vol. 30, No. 6, 01.12.1997, p. 313-320.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Comparison of effects of thrombolytic therapy followed by elective coronary intervention and direct coronary intervention in acute myocardial infarction

T2 - Usefulness of dobutamine stress echocardiography

AU - Hasegawa, K.

AU - Iwase, M.

AU - Matsuyama, H.

AU - Kimura, M.

AU - Koie, S.

AU - Kato, C.

AU - Yamamoto, H.

AU - Hatada, A.

AU - Ishii, Junichi

AU - Nomura, M.

AU - Watanabe, Y.

AU - Hishida, H.

PY - 1997/12/1

Y1 - 1997/12/1

N2 - The effects of intravenous administration of tissue plasminogen activator (t-PA) followed by elective percutaneous transluminal coronary angioplasty (PTCA) were compared to those of direct PTCA (d-PTCA) in patients with acute myocardial infarction using dobutamine stress echocardiography 1 week and 1 month after the acute episode. There were 12 patients in the t-PA group and nine patients in the d-PTCA group. Dobutamine was infused at incremental doses (5 μg/kg/min for each 5 min step). Wall motion changes were classified during infusion into four patterns, improvement, biphasic, worsening and no change. One week after the acute episode, seven of 12 patients in the t-PA group showed biphasic the pattern and five showed the improvement pattern. The biphasic pattern was observed in three patients in the d-PTCA group, worsening in one and improvement in five. One month later, the biphasic pattern in five patients in the t-PA group changed to the improvement pattern. No patients in the d-PTCA group showed changes in the wall motion pattern. There was no difference between the two groups in the frequency of the change of wall motion patterns I week and I month after infarction, but the improvement pattern was significantly increased from five to 10 patients in the t-PA group after 1 month (p<0.05). The sensitivity, specificity and accuracy of the biphasic pattern in the t-PA group for indicating remnant coronary stenosis were 78%, 100% and 83%, respectively. Evaluation of wall motion pattern by dobutamine stress echocardiography is useful for assessment of reperfusion therapy for acute myocardial infarction. The administration of t-PA followed by elective PTCA has similar efficacy to d-PTCA.

AB - The effects of intravenous administration of tissue plasminogen activator (t-PA) followed by elective percutaneous transluminal coronary angioplasty (PTCA) were compared to those of direct PTCA (d-PTCA) in patients with acute myocardial infarction using dobutamine stress echocardiography 1 week and 1 month after the acute episode. There were 12 patients in the t-PA group and nine patients in the d-PTCA group. Dobutamine was infused at incremental doses (5 μg/kg/min for each 5 min step). Wall motion changes were classified during infusion into four patterns, improvement, biphasic, worsening and no change. One week after the acute episode, seven of 12 patients in the t-PA group showed biphasic the pattern and five showed the improvement pattern. The biphasic pattern was observed in three patients in the d-PTCA group, worsening in one and improvement in five. One month later, the biphasic pattern in five patients in the t-PA group changed to the improvement pattern. No patients in the d-PTCA group showed changes in the wall motion pattern. There was no difference between the two groups in the frequency of the change of wall motion patterns I week and I month after infarction, but the improvement pattern was significantly increased from five to 10 patients in the t-PA group after 1 month (p<0.05). The sensitivity, specificity and accuracy of the biphasic pattern in the t-PA group for indicating remnant coronary stenosis were 78%, 100% and 83%, respectively. Evaluation of wall motion pattern by dobutamine stress echocardiography is useful for assessment of reperfusion therapy for acute myocardial infarction. The administration of t-PA followed by elective PTCA has similar efficacy to d-PTCA.

UR - http://www.scopus.com/inward/record.url?scp=0031473896&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031473896&partnerID=8YFLogxK

M3 - Article

VL - 30

SP - 313

EP - 320

JO - Journal of Cardiology

JF - Journal of Cardiology

SN - 0914-5087

IS - 6

ER -