Urgent cardiology department of Tomsk research cardiology institute discussed new acute coronary syndrome treatment approaches. Accelerated intravenous 10-15 minutes Streptokinase infusion is favorable modified times delay up to coronary artery reperfusion in myocardial infarction patients. This method had high safety and coronary artery opening rate. Prognosis of serious adverse events in elder patient was depended from myocardial necrosis extend, but not from thrombolythic therapy execution. Pulmonary edema and cardiogenic shock development in MI patients were most high negative prognosis survival index. Early thrombolysis, PCI and their combination increased MI patients survival. Recovery of myocardial function is a new approach for congestive heart failure treatment in post MI patients. Autological mononuclear cell transplantation by its intracoronary infusion is studied in urgent cardiology department.
Bolus i.v. administration of streptokinase (SK) 750 000 U within 5-10 min in AMI patients results in earlier reperfusion of infarct-related artery at equal rate of its opening compared to standard method ( infusion of 1.5 million U of SK within 60 min). Thrombolytic therapy using bolus i.v. administration of SK 750 000 U results in decreased rate of hemorrhagic complications, increased rate of short-term arterial hypotension which is easily stopped as compared to infusion of SK 1.5 million U in drops.
ADP-induced platelet aggregation was studied in 28 patients with myocardial infarction randomized, at admission, into three groups. Conventional therapy with heparin and antianginal drugs was combined with aspirin (250 mg/day, n = 9), tiklid (500 mg/day, n = 9), tiklid (500 mg/day) + aspirin (250 mg/day, n = 10) in group 1, 2 and 3, respectively. Tiklid diminished platelet aggregation more effectively than aspirin on the disease day 7 and 21. Tiklid + aspirin combination suppresses platelet aggregation more than monotherapy with either of the drugs, provides insignificant attenuation of postinfarction angina but is associated with a high risk of hemorrhagic complications.