Document Detail


Anisoylated plasminogen streptokinase activator complex (APSAC). A review of its mechanism of action, clinical pharmacology and therapeutic use in acute myocardial infarction.
MedLine Citation:
PMID:  3308411     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
APSAC is a new thrombolytic agent with advantages over conventional therapy such as streptokinase. In particular, it is suitable for intravenous administration over 4 to 5 minutes, in contrast with the prolonged infusion required with intravenous streptokinase, thus facilitating treatment of acute myocardial infarction outside a coronary care unit. Additionally, its fibrinolytic action is theoretically selective for fibrin associated with thrombi, which should minimise systemic fibrinolysis. However, in practice, systemic fibrinolysis does occur to some extent in most patients, but clinically significant haemorrhagic complications are rare. At the recommended dose of 30U injected intravenously over a period of 4 to 5 minutes in patients with acute myocardial infarction of less than 6 hours' duration, reperfusion of occluded coronary arteries occurs in about 72% of patients (range 53 to 91% in individual studies). Subsequent reocclusion has been reported in 0 to 20% of patients in most studies, with an average reocclusion rate of around 10%. The reperfusion rate compares favourably with that reported for intracoronary streptokinase and has tended to be superior to that with intravenous streptokinase. Thus, APSAC is an important advance in thrombolytic therapy for patients with acute myocardial infarction. Of particular importance is its relative ease of administration, reducing the dependence on coronary care units with catheterisation facilities, and the associated costs and delays in implementing treatment. APSAC should result in effective thrombolytic therapy being rapidly introduced after acute myocardial infarction in a wider proportion of patients than was previously feasible.
Authors:
J P Monk; R C Heel
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Drugs     Volume:  34     ISSN:  0012-6667     ISO Abbreviation:  Drugs     Publication Date:  1987 Jul 
Date Detail:
Created Date:  1987-10-29     Completed Date:  1987-10-29     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  7600076     Medline TA:  Drugs     Country:  NEW ZEALAND    
Other Details:
Languages:  eng     Pagination:  25-49     Citation Subset:  IM    
Affiliation:
ADIS Drug Information Services, Auckland.
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MeSH Terms
Descriptor/Qualifier:
Anistreplase
Fibrinolytic Agents / pharmacology*,  therapeutic use
Humans
Myocardial Infarction / drug therapy*
Plasminogen / pharmacology*,  therapeutic use
Streptokinase / pharmacology*,  therapeutic use
Chemical
Reg. No./Substance:
0/Fibrinolytic Agents; 81669-57-0/Anistreplase; 9001-91-6/Plasminogen; EC 3.4.-/Streptokinase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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