Document Detail


Intravenous anisoylated plasminogen streptokinase activator complex versus intravenous streptokinase in evolving myocardial infarction. Preliminary data from a randomised multicentre study.
MedLine Citation:
PMID:  3315581     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The efficacy of a single intravenous bolus of anisoylated plasminogen streptokinase activator complex (APSAC 30U in 4 to 5 minutes) versus an intravenous infusion of streptokinase (1.5 X 10(6) U in 60 minutes) was assessed in 86 patients with evolving myocardial infarction of less than 6 hours duration in a cooperative randomised study. The patency of the infarct-related artery was assessed by coronary angiography at, on average, 90 minutes after therapy (mean time: APSAC 95 minutes, streptokinase 105 minutes). The treatment groups were similar with respect to sex, age, location of myocardial infarction and the delay from onset of pain to treatment. The 90-minute patency rate (grade 2 to 3) was 71.8% in the APSAC group and 55.8% in the streptokinase group; the difference was not statistically significant. There was no difference between the drop in fibrinogen concentrations in the 2 groups at 3 or 24 hours. The minimal concentration obtained at the first assessment was +/- 0.2 g/L in the streptokinase group and 0.5 g/L in the APSAC group. One patient in the APSAC group, who had a previous meningeal bleeding, had a non-fatal cerebrovascular accident. In a subgroup of 38 patients who had 3 control coronary angiograms at 90 minutes, 24 hours and 3 weeks, the patency rate was 63, 82 and 93%, respectively, in the APSAC group and 48, 88 and 92%, respectively, in the streptokinase group (the difference was not statistically significant). None of the patients in the APSAC group presented with reocclusion, whilst 3 patients in the streptokinase group had reocclusions.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
M L Brochier; L Quilliet; H Kulbertus; P Materne; B Letac; A Cribier; J P Monassier; A Sacrez; J P Favier
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Drugs     Volume:  33 Suppl 3     ISSN:  0012-6667     ISO Abbreviation:  Drugs     Publication Date:  1987  
Date Detail:
Created Date:  1988-01-07     Completed Date:  1988-01-07     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7600076     Medline TA:  Drugs     Country:  NEW ZEALAND    
Other Details:
Languages:  eng     Pagination:  140-5     Citation Subset:  IM    
Affiliation:
Department of Cardiology, CHU Trousseau, Tours.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anistreplase
Fibrinogen / metabolism
Fibrinolytic Agents / adverse effects,  therapeutic use*
Heart Ventricles / drug effects
Humans
Infusions, Intravenous
Injections, Intravenous
Middle Aged
Myocardial Infarction / drug therapy*
Plasminogen / adverse effects,  therapeutic use*
Random Allocation
Streptokinase / adverse effects,  therapeutic use*
Vascular Patency / drug effects
Chemical
Reg. No./Substance:
0/Fibrinolytic Agents; 81669-57-0/Anistreplase; 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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