The German multicenter trial of anisoylated plasminogen streptokinase activator complex versus heparin for acute myocardial infarction.
A multicenter randomized trial of anisoylated plasminogen streptokinase activator complex (APSAC) versus heparin in patients with acute myocardial infarction of less than 4 hours' duration was undertaken in 19 hospitals. Of the 313 patients, 151 received heparin and 162 APSAC (30 U as intravenous injection). Within 28 days of hospital stay, 19 deaths (12.6%) occurred in the heparin group and 9 deaths (5.6%) in the APSAC group (p = 0.032). After 24 hours, patients in the APSAC group had a significantly lower incidence of cardiogenic shock (3.2 vs 9.5%, p = 0.031), asystole (3.8 vs 10.8%, p = 0.015) and need for resuscitation (5.1 vs 11.5%, p = 0.039). There was no difference in global and infarct-related ejection fraction between the 2 groups. Thus, APSAC favorably influences prognosis and clinical course in hospital.
D016255:Anistreplase; D001158:Arteries; D002986:Clinical Trials as Topic; D003331:Coronary Vessels / Q000503:physiopathology; D003402:Creatine Kinase / Q000097:blood; D005340:Fibrinogen / Q000097:blood; D006321:Heart / Q000503:physiopathology; D006352:Heart Ventricles; D006493:Heparin / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D010958:Plasminogen / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*; D013300:Streptokinase / Q000009:adverse effects / Q000627:therapeutic use*; D014654:Vascular Patency
D016255:Anistreplase; D005340:Fibrinogen; D010958:Plasminogen; D006493:Heparin; D003402:Creatine Kinase; D013300:Streptokinase