Evaluation of 2 intravenous thrombolytic agents (anisoylated plasminogen streptokinase activator complex versus streptokinase) in patients with acute myocardial infarction.
Ten patients with symptoms of acute myocardial infarction of less than 6 hours duration were randomised to receive either anisoylated plasminogen streptokinase activator complex [APSAC] (30U) or streptokinase (1,500,000U) intravenously. The aims of the study were to compare the angiographic patency of the infarct-related coronary arteries and to monitor drug safety and tolerance for up to 24 hours. The left anterior descending artery was occluded in 3, the left circumflex in 3 and right coronary artery in 4 patients. Time between onset of pain and treatment ranged from 150 to 330 minutes. At 90 minutes, 8 patients, 3 of 5 (60%) of the APSAC group and all of the streptokinase group, had patent arteries. No significant differences were found in measurements of coagulation. There were no haemorrhagic complications. One patient of the APSAC group had reinfarction 6 hours after treatment and died in cardiogenic shock. APSAC seems safe and is easier to use than streptokinase, and both agents result in patency in the majority of patients, although too few patients were included to allow a valid comparison. However, thrombolysis should be considered only a temporary solution in acute myocardial infarction, associated mainly with 3-vessel disease.
Seabra-Gomes
R
R
Hospital de Santa Cruz, Carnaxide.
Aniceto Silva
J
J
Aleixo
A
A
Real
T
T
Freire
I
I
Torres
I
I
Freitas
R
R
Crespo
F
F
D000368:Aged; D016255:Anistreplase; D017023:Coronary Angiography; D003402:Creatine Kinase / Q000097:blood; D004562:Electrocardiography; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000188:drug therapy*; D010958:Plasminogen / Q000378:metabolism / Q000627:therapeutic use*; D011897:Random Allocation; D013300:Streptokinase / Q000627:therapeutic use*; D014654:Vascular Patency / Q000187:drug effects
D005343:Fibrinolytic Agents; D016255:Anistreplase; D005340:Fibrinogen; D010958:Plasminogen; D003402:Creatine Kinase; D013300:Streptokinase