Concomitant use of intraaortic balloon counterpulsation and streptokinase in acute anterior myocardial infarction

Using a prospective, nonrandomized design, the authors sought to determine whether concomitant use of intraaortic balloon counterpulsation (IABP) and streptokinase in acute anterior myocardial infarction (MI) would improve th e in-hospital mortality rate and angiographic findings. The study included 45 patients with an acute anterior MI. All patients received intravenous st reptokinase. Among these, 25 patients had concomitant IABP while the remain ing 20 patients had streptokinase alone. All patients underwent cardiac cat heterization. Patients treated with concomitant IABP had a significantly hi gher frequency of thrombolysis in myocardial infarction (TIMI) grade 3 flow (n: 11; 44% vs n: 1; 5%, p<0.05), and there was a trend toward a lower in- hospital mortality rate in the IABP group (n: 0; 0% vs n: 3; 15%, p=0.08). The angiographic presence of thrombus image and grade greater than or equal to 2 coronary collateral circulation to the infarct-related coronary arter y for the IABP and non-IABP groups did not differ significantly. The prelim inary results of this study suggest that concomitant use of IABP and strept okinase in acute anterior MI increases the incidence of TIMI grade 3 flow a nd may have decreased the in-hospital mortality rate without unacceptable r ates of vascular or hemorrhagic complications.