title: Dose-ranging studies of anisoylated plasminogen streptokinase activator complex. Studies in healthy volunteers and in patients with acute myocardial infarction.
abstract: Anisoylated plasminogen streptokinase activator complex (APSAC) is well tolerated when given as an intravenous bolus dose over 2 to 4 minutes. The intravenous administration of 30U was rapidly effective in patients with coronary artery occlusion, with 82% of successfully treated patients responding to the initial APSAC dose after a mean time of about 30 minutes. The plasma fibrinogen and plasminogen concentrations decreased in all patients receiving APSAC 30U, which indicates that APSAC at this dose is not sufficiently fibrin-specific to dissolve thrombi without producing a lytic state. Side effects, complications and mortality were as expected for thrombolytic agents, with only 1 bleeding episode other than at the catheterisation site. Thus, APSAC offers unique advantages of rapid and simple bolus intravenous administration, with reperfusion rates achieved that are similar to those expected for intracoronary streptokinase and for intravenous tissue plasminogen activator.
authors.affiliation: Department of Medicine, University of Rochester School of Medicine and Dentistry.
authors.forename: V J
authors.initials: VJ
authors.lastname: Marder
authors.forename: R L
authors.initials: RL
authors.lastname: Rothbard
authors.forename: P G
authors.initials: PG
authors.lastname: Fitzpatrick
authors.forename: C W
authors.initials: CW
authors.lastname: Francis
authors.forename: E C
authors.initials: EC
authors.lastname: Norry
mesh_terms: D016255:Anistreplase; D001760:Bleeding Time; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007261:Infusions, Intra-Arterial; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D008297:Male; D009203:Myocardial Infarction / Q000188:drug therapy*; D010958:Plasminogen / Q000008:administration & dosage* / Q000009:adverse effects; D013300:Streptokinase / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D005343:Fibrinolytic Agents; D016255:Anistreplase; D010958:Plasminogen; D013300:Streptokinase