Ancrod causes rapid thrombolysis in patients with acute stroke.
Clot lysis is desirable in patients with thrombi in arteries and arterioles by a safe rapidly-acting thrombolytic agent. Ancrod cleaves fibrinogen; the resulting circulating ancrod-fibrin stimulates fibrinolysis. Ancrod action and effect were studied in 20 patients with acute developing stroke in a double-blind, placebo-controlled study. Patients were randomly assigned to one of two treatment groups, and received either normal saline or ancrod 0.5 mu/kg in normal saline administered as a constant-rate intravenous infusion over 6 hours. Subsequent doses of ancrod (or saline placebo) were determined daily thereafter for a total treatment period of 7 days. Neither bleeding nor re-thrombosis occurred within the 90 day follow-up period. That ancrod acted rapidly was shown by a significant decrease in functional plasminogen activator inhibitor (PA-I) within 60 minutes, and by significant elevations of fibrin(ogen) degradation products (FDP) and D-dimer within 3 and 4 hours. The biological effect of fibrinolysis in ancrod infused patients was demonstrated by a greater improvement in stroke score when compared to those infused with saline.
Department of Medicine, University of Cincinnati Medical Center, Ohio 45267-0585.
V E
VE
Pollak
P
P
Glas-Greenwalt
C P
CP
Olinger
N K
NK
Wadhwa
S A
SA
Myre
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000721:Ancrod / Q000627:therapeutic use*; D002561:Cerebrovascular Disorders / Q000097:blood / Q000188:drug therapy*; D004311:Double-Blind Method; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005340:Fibrinogen / Q000032:analysis; D005342:Fibrinolysis / Q000187:drug effects; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000097:blood / Q000188:drug therapy*; D008875:Middle Aged; D010865:Pilot Projects; D010958:Plasminogen / Q000032:analysis; D010960:Plasminogen Activators / Q000032:analysis; D015849:Plasminogen Inactivators / Q000032:analysis; D011486:Protein C / Q000032:analysis; D016032:Randomized Controlled Trials as Topic; D013997:Time Factors; D000979:alpha-2-Antiplasmin / Q000032:analysis
D005338:Fibrin Fibrinogen Degradation Products; D015849:Plasminogen Inactivators; D011486:Protein C; D000979:alpha-2-Antiplasmin; D005340:Fibrinogen; D010958:Plasminogen; D000721:Ancrod; D010960:Plasminogen Activators