Effect of Adjunctive Intracoronary Streptokinase on Late Term Left Ventricular Infarct Size and Volumes in Patients With Acute Myocardial Infarction

Istanbul University53 enrolled

Overview

The investigators hypothesized that complementary intracoronary streptokinase administration to primary percutaneous intervention in patients with acute myocardial infarction may provide limitation infarct size and improvement in left ventricular volumes and function in acute and late phases (6 months).

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

TRIPLE

Enrollment

Conditions

Acute Coronary Syndromes Acute Myocardial Infarction Reperfusion Injury

Interventions

StreptokinaseDRUG

intracoronary infusion, 250.000 Units

primary percutaneous coronary interventionPROCEDURE

balloon catheter, stent

Eligibility

Sex: ALLMin age: 20 YearsMax age: 75 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Continuous chest pain that lasted \> 30 minutes within the preceding 12 hours * ST-segment elevation of at least 1 mm in 2 contiguous leads on the ECG * Infarct related artery (IRA) occlusion (TIMI grade 0) at the angiography Exclusion Criteria: * Contraindications to streptokinase, tirofiban, aspirin, clopidogrel, or heparin * Culprit lesion in saphenous vein graft * TIMI grade II-III flow in IRA * Additional epicardial stenosis in the IRA distal to stented segment (significant or insignificant) * Presence of left bundle branch block * History of prior MI

Locations (1)

Istanbul University, Istanbul Faculty of Medicine, Department of Cardiology

Istanbul, Turkey (Türkiye)

Outcomes

Primary Outcomes

Left ventricular infarct size by SPECT

Time frame: at long term (5-6 months)

Left ventricular diastolic volume

Time frame: at long term (5-6 months)

Left ventricular systolic volume

Time frame: at long term (5-6 months)

Left ventricular ejection fraction

Time frame: at long term (5-6 months)

Secondary Outcomes

Temporal changes (from baseline to 5 months follow-up) in microvascular perfusion indices (index of microvascular resistance, coronary flow reserve) and in infarct size have been interrogated in only control group.

Time frame: early phase (at discharge) and late phase (5-6 months)

Reinfarction

Time frame: from recruitment until the last follow-up at 5-6 months

Major bleeding

Time frame: from recruitment to discharge

Data from ClinicalTrials.gov

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