ECHOCARDIOGRAPHIC ASSESSMENT OF LEFT-VENTRICULAR FUNCTION IN PATIENTSWITH ACUTE MYOCARDIAL-INFARCTION RANDOMLY TREATED WITH STREPTOKINASE OR HEPARIN

One hundred and eighty-three patients with acute myocardial infarction (AMI) were randomly assigned to receive either streptokinase (SK; n = 97) or heparin (n = 86) intravenously within 6 h after onset of sympt oms. The left ventricular (LV) function was evaluated by means of two- dimensional echocardiography on days 1, 3, 7, and 21 after AMI. In com parison to baseline study, the echocardiographic wall motion score ind ex improved gradually, reaching statistical significance on day 21 in the SK-treated group (p < 0.02). Significant improvement of LV functio n on day 21 was observed in patients treated with SK within 3 h after AMI (p = 0.001) and in SK-treated patients with anterior infarction (p = 0.004). No significant changes in wall motion score index were foun d for inferior AMI patients treated with SK within 3 hours after sympt oms onset nor for any patients treated with heparin. These data sugges t that intravenously administered SK has a beneficial effect on LV fun ction only in patients with anterior AMI treated within 3 h after the onset of symptoms. Heparin does not improve the LV function in patient s with AMI.