[Experiences at a peripheral hospital with the intracoronary administration of streptokinase and urokinase in acute heart infarct].

In 285 patients intracoronary fibrinolytic agents were administered 300 times during the acute phase of a myocardial infarction. The results and the complications of this therapy, as administered in a community hospital, did not differ from those obtained in a big randomized study performed by the Interuniversity Cardiological Institute of The Netherlands. Recanalization of a completely occluded coronary artery was obtained in 79% of the cases. Only 8.3% of the patients needed blood transfusion because of blood loss via the puncture in the femoral artery. No intracranial bleeding occurred. Actuarial total survival after 12 months was 90.5%. The incidence of recurrent myocardial infarction after successful intracoronary fibrinolytic therapy appears rather high; therefore, in some patient categories further therapy may be considered such as percutaneous transluminal coronary angioplasty or aortocoronary bypass surgery.