Clinical effects and kinetic properties of intravenous APSAC--anisoylated plasminogen-streptokinase activator complex (BRL 26921) in acute myocardial infarction.
Fifty patients with a first myocardial infarction presenting within 4 hours of the onset of symptoms were treated with intravenous anisoylated plasminogen-streptokinase activator complex (APSAC-BRL 26921). Vessel patency with good flow was documented in 88%. The left ventricular ejection fraction declined with the duration of symptoms before treatment (r = -0.53, P less than 0.001). The correlation persisted for the group with anterior infarction (r = -0.46, P less than 0.05) where the mean left ventricular ejection fraction prior to discharge from hospital was 36 +/- 9% compared to 49 +/- 7% for the group with inferior infarction. Reinfarction developed in 12% and mortality at 6 months for the whole group was 6%. A degree of systemic fibrinolysis did occur with a fall in mean plasma fibrinogen from 3.20 g/l to 1.08 g/l. A pharmacokinetic study was performed in six patients demonstrating a clearance half-life of fibrinolytic activity of 87.5 +/- 5.0 min. APSAC is an effective intravenous thrombolytic agent with a relatively long half-life of fibrinolytic activity.
D000328:Adult; D000368:Aged; D016255:Anistreplase; D005340:Fibrinogen / Q000032:analysis; D005500:Follow-Up Studies; D006207:Half-Life; D006321:Heart / Q000503:physiopathology; D006487:Hemostasis; D006801:Humans; D007263:Infusions, Parenteral; D007700:Kinetics; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D010958:Plasminogen / Q000378:metabolism / Q000627:therapeutic use*; D012008:Recurrence; D013300:Streptokinase / Q000378:metabolism / Q000627:therapeutic use*; D013997:Time Factors
D016255:Anistreplase; D005340:Fibrinogen; D010958:Plasminogen; D013300:Streptokinase