[Intravenous high-dose short-term fibrinolysis in myocardial infarct. Experiences with 60 patients].

Sixty patients with suspected myocardial infarction were treated in an open study with intravenous high-dose streptokinase (1.5 million U in 70 min). The average delay between onset of pain and fibrinolysis was 270 min. Reperfusion parameters were fast resolution of pain, rapid decline of ST elevation, arrhythmias and early CK peak. 27 patients were judged on the basis of these criteria as successfully reperfused, 13 as questionable and 20 as failures. Adverse events were 6 hypotensive episodes, 3 hypertensive phases, 2 interruptions due to flush, 1 chill, and 7 minor bleeding episodes. During follow-up there were 2 early deaths from cardiogenic shock. 58 patients were followed for 6-41 months, during which 4 died, 17 had a coronary angiogram and 6 were treated by bypass operation. 35 patients were able to work full-time and 7 half-time. Intravenous high-dose fibrinolysis is harmless and can be done in community hospitals.