title: HTUPA as a new thrombolytic agent for acute myocardial infarction: a multicenter, randomized study.
abstract: BACKGROUND
  It is necessary to develop a new thrombolytic agent which can be used by a single bolus at first aid sites to decrease the time to reperfusion in clinical practice. HTUPA, a genetically engineered new thrombolytic with a longer half-life, is well qualified. We aim to compare the thrombolytic efficacy and safety of human tissue urokinase type plasminogen activator (HTUPA) to recombinant tissue plasminogen activator (rt-PA) in Chinese patients with acute myocardial infarction (AMI).
  
  
  METHODS
  AMI patients (n=221) were randomized to rt-PA (a standard protocol) or HTUPA (25 mg bolus) treatment groups. All patients also received oral aspirin and intravenous heparin. Coronary angiography was performed 90 min after therapy initiation to determine infarct-related coronary artery (IRA) patency. Clinical outcomes and changes of clotting variables, heart rate, blood pressure, left ventricular ejection fraction (LVEF), and electrocardiogram were evaluated.
  
  
  RESULTS
  Patent IRA [thrombolysis in myocardial infarction (TIMI) grade 2 or 3] was observed in 77% of HTUPA-treated patients, compared to 76% of rt-PA-treated patients (P=0.76). TIMI grade 3 patency rates were 52% and 44% in the HTUPA and rt-PA groups, respectively (P=0.37). The total patency rate was 77% (86/111 patients) in the HTUPA group and 73% (80/110 patients) in the rt-PA group (P=0.41). Adverse events were infrequent in both groups, and no significant differences were detected in mortality, re-occlusion rate, revascularization rate, adverse effects, clotting index, LVEF, or electrocardiogram between the two groups.
  
  
  CONCLUSIONS
  Intravenous HTUPA had a safe and efficacious profile as good as rt-PA in patients with AMI.
authors: Department of Cardiology, the First Hospital of China Medical University, Shenyang, People's Republic of China. Electronic address: sunyingxian12@yahoo.com.cn.
authors: Yingxian
authors: Y
authors: Sun
authors: Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China.
authors: Xingli
authors: X
authors: Liu
authors: Department of Cardiology, the First Hospital of China Medical University, Shenyang, People's Republic of China.
authors: Liang
authors: L
authors: Guo
authors: Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China.
authors: Wenyue
authors: W
authors: Pang
authors: Department of Cardiology, the First Hospital of China Medical University, Shenyang, People's Republic of China.
authors: Xiaofan
authors: X
authors: Guo
authors: Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China.
authors: Zhaoqing
authors: Z
authors: Sun
authors: Department of Cardiology, Liaoning Provincial Hospital, Shenyang, People's Republic of China.
authors: Zhanquan
authors: Z
authors: Li
authors: Department of Cardiology, Affiliated Hospital of Inner Mongolia University, Hohhot, People's Republic of China.
authors: Xiaoying
authors: X
authors: Cui
authors: Department of Cardiology, The General Hospital of Daqing Oil Field, Daqing, People's Republic of China.
authors: Hui
authors: H
authors: Li
authors: Department of Cardiology, Affiliated Hospital of Liaoning Medical College, Jinzhou, People's Republic of China.
authors: Guizhou
authors: G
authors: Tao
authors: Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin, People's Republic of China.
authors: Lanfeng
authors: L
authors: Wang
authors: Department of Cardiology, Affiliated Hospital of Qingdao University School of Medicine, Qingdao, People's Republic of China.
authors: Changyong
authors: C
authors: Zhou
authors: Department of Cardiology, Liaoning Provincial Hospital, Shenyang, People's Republic of China.
authors: Ying
authors: Y
authors: Liu
authors: Department of Cardiology, Affiliated Hospital of Inner Mongolia University, Hohhot, People's Republic of China.
authors: Hongwei
authors: H
authors: Shan
authors: Department of Cardiology, The General Hospital of Daqing Oil Field, Daqing, People's Republic of China.
authors: Manqing
authors: M
authors: Wang
authors: Department of Cardiology, Affiliated Hospital of Liaoning Medical College, Jinzhou, People's Republic of China.
authors: Mingxin
authors: M
authors: Liu
authors: Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin, People's Republic of China.
authors: Jia
authors: J
authors: Li
authors: Department of Cardiology, Affiliated Hospital of Qingdao University School of Medicine, Qingdao, People's Republic of China.
authors: Lei
authors: L
authors: Yin
authors: Heart Center, Peking University People's Hospital, Beijing, People's Republic of China.
authors: Dayi
authors: D
authors: Hu
mesh_terms: D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D001794:Blood Pressure / Q000502:physiology; D002681:China; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006339:Heart Rate / Q000502:physiology; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D013318:Stroke Volume / Q000502:physiology; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use*; D014654:Vascular Patency
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents; D006493:Heparin; D014568:Urokinase-Type Plasminogen Activator; D001241:Aspirin
keywords: Acute myocardial infarction; HTUPA; Patency; Thrombolysis; rt-PA