SAW Vol. 17. No. 2 February I991 MA

Island. BeIlevue Hospital, wiLJniversity, Providence, Rhode

is shown below.

90’ n FG No Change

0.1 5 4 (80.6%) 0 2 2 8 (36.4%) 8 (36.4%) 3 29 (87.9%) --

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BENEFICIAL EFFECT OF STREPTOKINASE AFTER ACUTE P~YOCARDAAL INFARCTION

IN THE FIRST 4 CAYS

Florence H. Sheehan, Claude Thery, Philippe Durand, Mlchel E. Bertrand, Edward L. Bolson, University of Washington, Seattle, WA

The effect cf intrsre:louf streptckinase (SF) thcrnp; on the time course of functional recovery was investigated in a controlled study of 64 patients (ptsj randomized within 3 hss after onset of acute myocardial infarction (AMI) at the H8pital Cardiologique, Lille, France. Contrast ventriculography was performed 1-4 d after AMI and 5 wks later. Wall motion was analyzed by the centerline method in the central infarct region (CIR), peripheral infarct region (PIR) and noninfarct

region !rJIR).

Amon, pts with anaiyrable ventriculograms at the first study, SK treated pts had less severe hypokinesis in the CIR than control p?s (-2.9 ? 0.9, N=29, vs -3.4 f 0.7 SD, Nw21, p<0.35) The benefit of SK was more marked in the PIR (-1.5 2 0.: vs -2.1 -+ 0.6 SD, p<O.OOl). As a result, the ejtction fraxion was slightly higher in SK pts (46 2 10 vs 43 i 7%, respectively, p=NS). At 5 wks, function in the SK and control pts diverged further due to continued improvement in SK-treated pts.

This study shows that SK benefits LV function earlier after AMI than previously reported. The benefit was not limited to the PIR, where ischemia might have been less severe, but was also seen in the CIR. The inference is that SK can improve LV function during the period of myocardial stunning, while myocardial function is still recovering.