Document Detail


Intracoronary thrombolysis with an acylated streptokinase-plasminogen activator (BRL 26921) in patients with acute myocardial infarction.
MedLine Citation:
PMID:  6429226     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The fibrinolytic efficacy and systemic effects on coagulation variables of intracoronary administration of an acylated streptokinase-plasminogen complex (BRL 26921) were assessed in 23 patients with an acute transmural myocardial infarction. The infarct vessel was totally occluded in 22 patients and subtotally stenosed in 1 patient. Reperfusion was achieved in a total of 17 patients (74%), in 2 patients with the use of a guide wire. Reperfusion time in those patients treated with BRL 26921 alone amounted to 42 +/- 37 minutes. Reocclusion occurred in two patients subsequently. Four patients died; in two of these, intracoronary thrombolysis was unsuccessful. Reptilase time increased from 13 +/- 3 to 49 +/- 31 seconds (p less than 0.001), fibrinogen levels decreased from 280 +/- 65 to 126 +/- 76 mg% (p less than 0.001). Factor V decreased from 96 +/- 11 to 53 +/- 26% (p less than 0.001), and factor VIII from 99 +/- 1 to 55 +/- 36% (p less than 0.001). Peripheral hyperplasminemia, defined as a reduction of fibrinogen (less than 100 mg%) with a reduction of factor V and VIII (less than 75%) simultaneously occurred in eight patients. Six (75%) of these 8 patients demonstrated reperfusion, whereas 9 (64%) of 14 patients without peripheral hyperplasminemia were also successfully reperfused. Bleeding complications occurred in two patients who demonstrated hyperplasminemia. Thus, effective intracoronary thrombolysis could be achieved with only minor effects on peripheral coagulation variables in the majority of patients.
Authors:
W Kasper; R Erbel; T Meinertz; M Drexler; A Rückel; T Pop; W Prellwitz; J Meyer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  4     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1984 Aug 
Date Detail:
Created Date:  1984-08-21     Completed Date:  1984-08-21     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  357-63     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Anistreplase
Coronary Vessels / pathology
Drug Evaluation
Factor V / analysis
Factor VIII / analysis
Female
Fibrin Fibrinogen Degradation Products / analysis
Fibrinogen / analysis
Fibrinolytic Agents / adverse effects,  therapeutic use*
Humans
Male
Middle Aged
Myocardial Infarction / blood,  drug therapy*,  pathology
Plasminogen / adverse effects,  analysis,  therapeutic use*
Streptokinase / adverse effects,  therapeutic use*
Thrombin Time
Chemical
Reg. No./Substance:
0/Fibrin Fibrinogen Degradation Products; 0/Fibrinolytic Agents; 81669-57-0/Anistreplase; 9001-24-5/Factor V; 9001-27-8/Factor VIII; 9001-32-5/Fibrinogen; 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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