Effect of thrombolytic therapy on parameters of endothelial function in patients with myocardial infarction

The aim of study. A comparative estimation of influence various thrombolytic preparations (alteplase, streptokinase) on clinical course and the remote forecast of disease, and also of parameters of a metabolism of nitric oxide of the patient with acute myocardial infarction. Material and methods. In research have included 70 patients with acute myocardial infarction (MI) with rise of segment ST. Patients have been divided into groups depending on a kind of applied thrombolytic agent. Estimated features of clinical current by MI in both groups of patients, year forecast of disease, parameters of a metabolism nitric oxide and oxidative stress and antioxidative defence during the acute period of MI. Results. Greater efficiency thrombolytic therapies is revealed in group of patients with application of alteplase. The patients in group of alteplase were characterized by more favorable current both acute, and remote periods of MI. In these patients more significant activation of parameters of oxidative stress is revealed, than in group with application of streptokinase. This is caused by more effective revascularisation and reperfusion of myocardium. In group of patients treate with the streptokinase decrease in a level of stable metabolites of nitric oxide is more marked, than in group with application of alteplase. Statistically significant increase of this parameters is revealed in group of patients with alteplase displaing with endothelial protection by alteplase. Conclusion. Advantages of the tissue plasminogen activator alteplase concerning influence on clinical course of the acute period of MI and the remote forecast are shown, that, apparently, is connected not only with greater frequency of effective revascularization of a myocardium, but also with optimization of endothelial functions of patients with MI.