[Thrombolytic therapy of myocardial infarction. Prognostic value of early reduction of elevation of ST segment].

In-hospital mortality, infarction mass (estimated enzymatically) and electrocardiographic indexes (total ST-segments elevation, number of leads with R-wave presence and total R-waves amplitude) were assessed in 532 patients with acute myocardial infarction, randomized to two treatment groups: 272 treated with streptokinase (SK) and 260 with heparin (H). Echocardiographic contractility indexes (contractility disturbances area index, contractility disturbances index, left ventricle diastolic diameter) and heart volume estimated from X-ray film were also assessed. There were no significant differences in mortality and infarction area between the two groups. In 175 patients total ST-segments elevation was reduced by at least 50%, in the rest 340 patients this reduction was less significant. In the group with early elevated ST-segment reduction there were less in-hospital deaths (p less than 0.01), smaller infarction mass (p less than 0.0001) and significantly less disturbed electrocardiographic contractility indexes. Results suggest that simple electrocardiographic index, namely reduction of ST-segment elevation by 50% after 2 hours of treatment may be a useful prognostic tool, independent on treatment options, as far as in-hospital mortality, necrosis mass and left ventricle contractility disturbances are concerned.