[Possibilities of the use of 99mTc pyrophospate myocardial scintigraphy in the early period of myocardial infarct in the evaluation of the effectiveness of thrombolytic therapy]

In early (mean time, 6.9 +/- 0.2 hours following the onset of an anginal episode), 99mTc pyrophosphate myocardial scintigraphy was performed in 28 patients who received thrombolytic therapy under angiographic monitoring. The sensitivity and specificity of an early administration of pyrophosphate into the myocardium as a noninvasive marker of successful coronary reperfusion was 95.7% and 100%, respectively.

[Thrombolytic treatment of myocardial infarction at the prehospital and hospital stage]

Thrombolytic therapy was performed in 59 patients within the first hours of myocardial infarction. Twenty three patients (Group 1) were given streptokinase (SK) by an emergency team, 36 patients (Group 2) received SK following coronary angiography. In Group 1, SK was initiated earlier (p less than 0.001) than in Group 2. In Group 1 there was no coronary artery occlusion in the appropriate site of myocardial infarction in 86% of the patients. In Group 2, coronary occlusion was detected in 88% reperfusion, in 50% of the cases. Severe overall and regional left ventricular contractility abnormalities were found within the first month of the disease. The incidence of complications is the same in the two groups. High efficiency and relatively safe of thrombolytic therapy in the prehospital period makes this method particularly promising for practical medicine.