The intracoronary administration of urokinase following direct PTCA for acute myocardial infarction reduces early restenosis.
Early restenosis after successful percutaneous transluminal coronary angioplasty (PTCA) without antecedent thrombolytic therapy in patients with acute myocardial infarction (AMI) was assessed by performing in-hospital cardiac catheterization in 62 (88%) of 70 consecutive patients. Specific attention was focused on the effectiveness of the intracoronary administration of urokinase in cases with angiographic residual thrombus after successful direct PTCA. The following two treatment regimens were used: PTCA alone (43 patients) and PTCA followed by the intracoronary infusion of urokinase (27 patients). The rate of early restenosis was higher after successful direct PTCA alone (28%) than after direct PTCA followed by intracoronary urokinase (5%). Bleeding complications were no different between the two groups. These findings suggest that intracoronary urokinase can be effective in reducing early restenosis in patients with angiographic residual thrombus after successful direct PTCA. Therefore early restenosis may be related to residual intracoronary thrombus.
Morishita
H
H
Department of Internal Medicine, Faculty of Medicine, Kyoto University, Japan.
Hattori
R
R
Aoyama
T
T
Kawai
C
C
Yui
Y
Y
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000150:complications / Q000517:prevention & control / Q000628:therapy*; D003331:Coronary Vessels; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000628:therapy*; D012008:Recurrence; D012189:Retrospective Studies; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage* / Q000627:therapeutic use
D014568:Urokinase-Type Plasminogen Activator