[Chronic intermittent urokinase therapy in therapy-refractory angina pectoris].
To assess the effect of urokinase-induced reduction of fibrinogen concentration on myocardial perfusion, urokinase infusions were administered for 3 months to 24 men (mean age 59 +/- 10 years) in the inoperable end-stage of coronary heart disease with treatment-resistant angina pectoris. Initially 500,000 IU urokinase were infused i.v. daily until a fibrinogen concentration of 150-200 mg/dl was reached. Treatment was then continued as out-patients at a dosage of 500,000 IU two to four times per week. After 12 weeks the fibrinogen concentration had fallen from 348 +/- 88 to 211 +/- 52 mg/dl and plasma viscosity from 1.44 +/- 0.08 to 1.33 +/- 0.09 mPa.s (P for each less than 0.01). Up to the end of 12 weeks after the end of treatment the frequency of anginal attacks fell significantly from 3.2 +/- 1.6 to 0.7 +/- 0.4 daily (P less than 0.01), while ergometric exercise capacity increased by 76%. Thallium myocardial scintigraphy demonstrated an increased perfusion in all but three of 19 patients, global in 10, regional in 6. These results indicate that in patients with treatment-resistant angina due to coronary heart disease chronic intermittent urokinase infusion provides a promising treatment alternative.
Leschke
M
M
Abteilung für Kardiologie, Pneumologie und Angiologie, Universität Düsseldorf.
Höffken
H
H
Motz
W
W
Blanke
H
H
Schöbel
F
F
Strauer
B E
BE
D000368:Aged; D000787:Angina Pectoris / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D001809:Blood Viscosity / Q000187:drug effects; D002908:Chronic Disease; D003327:Coronary Disease / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy; D004341:Drug Evaluation; D005080:Exercise Test; D005340:Fibrinogen / Q000032:analysis / Q000187:drug effects; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D013794:Thallium Radioisotopes; D013997:Time Factors; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage*
D013794:Thallium Radioisotopes; D005340:Fibrinogen; D014568:Urokinase-Type Plasminogen Activator
Chronisch-intermittierende Urokinasetherapie bei therapierefraktärer Angina pectoris.