Author/Editor     Pernat, A; Pohar, B; Horvat, M
Title     Effect of hydrocortisone on streptokinase-induced hypotension in patients with acute myocardial infarction
Type     članek
Source     Fibrinolysis Proteolysis
Vol. and No.     Letnik 11, št. 2
Publication year     1997
Volume     str. 102-7
Language     eng
Abstract     Objective: A fall in blood pressure frequently occurs during infusion of streptokinase in patients with acute myocardial infarction. In the present study, we investigated the effect of hydrocortisone on blood pressure during streptokinase infusion in patients with acute myocardial infarction. Design and subjects: A double blind, placebo-controlled study was performed. We included 182 consecutive patients treated for acute myocardial infarction. Interventions: Patients were randomly allocated to receive an intravenous injection of 100 mg hydrocortisone (n=91, treated group) or an equal volume of saline (n=91, control group) before the commencement of streptokinase infusion. They were treated with intravenous infusion of 1.5 x 10/6 IU streptokinase over one hour. Systemic blood pressure was measured with a manual sphygmomanometer at least 5 min before the commencement, during and 60 min after the end of streptokinase infusion. Difference in blood pressure before, and the lowest blood pressure during, infusion was then recorded as maximal fall in blood pressure. Results: A maximal fall in systolic blood pressure (SBP) during infusion was significantly lower in the treated group (28 +- 23 (SD) vs 34 +- 24 mm Hg; P = 0.046). There was no significant difference in maximal fall in diastolic blood pressure between the two groups. In a small group of patients who were hypotensive before SK infusion (SBP < 100 mm Hg), fall in systolic and diastolic blood pressure seems to be effectively prevented. However, the difference between these subgroups are inconclusive owing to there being too small a number for statistical analysis. Conclusion: We conclude that hydrocortisone diminishes a maximal fall in systolic blood pressure during streptokinase infusion in patients with acute myocardial infarction, but has no effect on a fall in diastolic blood pressure. In hypotensive patients the effect of hydrocortisone seems to be even more (Abstract truncated at 2000 characters).
Descriptors     MYOCARDIAL INFARCTION
STREPTOKINASE
HYPOTENSION
HYDROCORTISONE
INFUSIONS, INTRAVENOUS
DOUBLE-BLIND METHOD
BLOOD PRESSURE
ADULT