| Author/Editor | Pernat, Andrej | |
| Title | Vpliv hidrokortizona na sistemski arterijski tlak med kratkotrajno sistemsko infuzijo streptokinaze pri bolnikih z akutnim srčnomišičnim infarktom | |
| Type | monografija | |
| Place | Ljubljana | |
| Publisher | Medicinska fakulteta | |
| Publication year | 1996 | |
| Volume | str. 56 | |
| Language | slo | |
| Abstract | In patients with acute myocardial infarction a transient fall in blood pressure frequently occurs during streptokinase (SK) infusion. This fall can depress efficacy of coronary thrombolysis induced by thrombolytic agents. The aim of our study was to evaluate whether treatment with hydrocortisone reduces fall in blood pressure (BP) during SK infusion in patients with acute myocardial infarction. We also wanted to identify subgroups of patients which would especially benefit from the effect of hydrocortisone, and to find out factors which affect BP during SK infusion. 182 patients with acute myocardial infarction were included in a double blind, placebo controlled prospective study. A11 were treated with systemic infusion of SK. Half of them received 100 mg of hydrocortisone intravenously before the start of SK infusion, the other half received 2 ml of saline intravenously. Blood pressure was measured twice before SK infusion, at the beginning of infusion and 5, 10, 15, 20, 25, 30, 35, 40, 50, 60, 80, 100 and 120 minutes after the beginning of infusion. In patients who received hydrocortisone, the maximal fall in systolic BP during SK infusion was 18% lower than in patients who received placebo (28 +- 23 (SD) vs 34 +- 24 mm Hg, p=0.046). There were no significant differences in the maximal fall in mean and diastolic BP between the two groups. In the subgroup with systolic BP lower than 100 mm Hg the effect of hydrocortisone was even more pronounced. In patients who received hydrocortisone the maximal fall in systolic BP was 65% lower, the maximal fall in mean BP 40% lower, and the maximal fall in diastolic BP 29% lower than in the placebo group. However, the difference between the two groups is not significant. The only factor with a significant correlation with the lowest systolic BP during infusion was systolic BP before SK infusion. (Abstract truncated at 2000 characters) | |
| Descriptors | MYOCARDIAL INFARCTION STREPTOKINASE HYDROCORTISONE INFUSIONS, INTRAVENOUS BLOOD PRESSURE THROMBOLYTIC THERAPY HYPOTENSION ACUTE DISEASE TIME FACTORS |