Value of thrombolytic therapy in acute myocardial ischemia after administration of kinin system inhibitors

: An experimental study in dogs showed that thrombolytic revascularization after 4 to 6 hours of coronary arterial occlusion resulted in further deterioration of ischemia and an impairment of cardiac contractility and hemodynamics. Micromorphologically, multiple extravasations were demonstrated in the ischemized region in combination with insignificant glycogen content. The administration of thrombolytics was accompanied by enhanced fibrinolytic activity, yet the activation of the first three phases of blood coagulation showed no decline. In a series with thrombolytic therapy preceded by contrykal and heparin infusions, micromorphology revealed no intramyocardial hemorrhages in the ischemized region. Active functional cells showed micro- and macrogranular glycogen that accumulated into clusters in myocardial fibres. The significant postrevascularization decline in ischemia was accompanied by improved myocardial contractility and cardiac hemodynamics in the presence of hypocoagulation and increased fibrinolytic activity.