Is Optimal Streptokinase Treatment Possible for Every Patient with Myocardial Infarction?

Abstract

Recanalization in a developing myocardial infarction is a most worthy goal indeed inasmuch as it attempts to restore oxygen supply to the cardiac muscle deprived of its usual perfusion of oxygen rich blood when an intracoronary thrombus has formed. It also aims at restoring coronary vascular reserve to levels which can never be reached by drugtherapy. The very logic of this approach has allowed it so far to compete within the ever tightening budget of health expenditures. Nevertheless, comparisons as to its efficacy must be made in terms of its long-term effect, such as one year mortality and resteration of ventricular function, against other treatments which are considerably less expensive. It behooves the intelligent scientific researcher to consider such matters relatively early, at least just after the initial stage in proving the efficacy of new treatment has been established. It is quite clear that the case in favor of intracoronary streptokinase for some patients has now been made in that it has not only been shown that left ventricular function improves after successful recanalization, in the majority of patients, but also that there is a significant reduction in one year mortality in at least one subset of patients.