title: Comparison of results of intravenous infusion of anistreplase versus streptokinase in acute myocardial infarction.
abstract: This randomized study compares the coronary perfusion rate in patients with acute myocardial infarction (AMI) treated with 2 different intravenous thrombolytic agents: streptokinase 1.5 million U given over 60 minutes and anisoylated human plasminogen streptokinase activator complex (anistreplase) administrated as a bolus of 30 U over 5 minutes. One hundred seventy-five patients (149 men and 26 women, mean age 54 years) have been included in this study. Eighty-nine patients were treated with anistreplase and 86 patients with streptokinase. AMI was inferior in 54 patients (61%) in the anistreplase group and in 54 patients (63%) in the streptokinase group. It was anterior in 35 (40%) and 32 (37%) patients, respectively. Coronary angiography and ventriculography were performed at a mean time (+/- SEM) of 207 +/- 11 minutes after the beginning of thrombolysis in 170 patients. A perfusion score grade of 2 or 3 according to the Thrombolysis in Myocardial Infarction trial was found in 63 patients (72%) in the anistreplase group and in 56 patients (68%) in the streptokinase group (p = NS). Severe bleeding occurred in 7 patients (8%) after anistreplase and in 6 patients (7%) after streptokinase. No cerebral hemorrhage occurred. Nine patients (5%) died during their hospital stay: 6 after anistreplase and 3 after streptokinase. It is concluded that intravenous administration of anistreplase or streptokinase is efficient and safe. Coronary patency 207 minutes after fibrinolysis, incidence of adverse events and mortality are similar in both groups.
authors.affiliation: Division de Cardiologie, Centre Hospitalier Universitaire, Lausanne, Switzerland.
authors.forename: P
authors.initials: P
authors.lastname: Vogt
authors.forename: P
authors.initials: P
authors.lastname: Monnier
authors.forename: M D
authors.initials: MD
authors.lastname: Schaller
authors.forename: J J
authors.initials: JJ
authors.lastname: Goy
authors.forename: P
authors.initials: P
authors.lastname: Beuret
authors.forename: A
authors.initials: A
authors.lastname: Essinger
authors.forename: F
authors.initials: F
authors.lastname: Bachmann
authors.forename: J
authors.initials: J
authors.lastname: Hauert
authors.forename: C
authors.initials: C
authors.lastname: Perret
authors.forename: U
authors.initials: U
authors.lastname: Sigwart
mesh_terms: D000328:Adult; D000368:Aged; D016255:Anistreplase / Q000008:administration & dosage* / Q000009:adverse effects; D016009:Chi-Square Distribution; D017023:Coronary Angiography / Q000187:drug effects; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D012044:Regression Analysis; D013300:Streptokinase / Q000008:administration & dosage* / Q000009:adverse effects; D015912:Thrombolytic Therapy / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D013997:Time Factors
chemical_list: D016255:Anistreplase; D013300:Streptokinase