Recombinant single-chain urokinase-type plasminogen activator during acute myocardial infarction

Am J Cardiol. 1988 May 1;61(13):966-70. doi: 10.1016/0002-9149(88)90107-5.

Abstract

Recombinant single-chain urokinase-type plasminogen activator was intravenously administered in 2 different doses in 24 patients with acute myocardial infarction and angiographically proved occlusion of the infarct-related artery. Patients with first infarction without contraindications of thrombolysis were treated within the first 4 hours after the onset of symptoms. Group A (12 patients) received 20 mg of rscu-PA as a bolus followed by 60 mg infused over 1 hour and group B received 10 mg as a bolus and 30 mg as infusion. The 2 groups showed no significant difference in age, sex, height, weight, time between onset of symptoms and start of therapy, peak values and course of infarct-related enzymes. Time to reperfusion was 43 minutes in group A versus 67 minutes in group B (p less than 0.005). The rate of reperfusion 90 minutes after start of treatment was 91% in group A and 50% in group B (p less than 0.001). Plasma levels of fibrinogen, plasminogen and alpha-2-antiplasmin did not differ significantly in both groups. Systemic lytic state (fibrinogen less than 100 mg/dl) occurred in 33% of group A and in 9% of group B. Intravenous infusion of 80 mg (but not 40 mg) of rscu-PA led to reperfusion of the occluded coronary artery in nearly all patients. Approximately one-third of the patients treated with this dose demonstrated systemic lysis.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Review

MeSH terms

  • Adult
  • Aged
  • Clinical Trials as Topic
  • Coronary Circulation / drug effects
  • Female
  • Fibrinogen / analysis
  • Fibrinolytic Agents / administration & dosage
  • Fibrinolytic Agents / pharmacology
  • Fibrinolytic Agents / therapeutic use*
  • Follow-Up Studies
  • Hemostasis / drug effects
  • Humans
  • Infusions, Intravenous
  • Injections, Intravenous
  • Male
  • Middle Aged
  • Myocardial Infarction / blood
  • Myocardial Infarction / drug therapy*
  • Plasminogen / analysis
  • Plasminogen Activators / administration & dosage
  • Plasminogen Activators / pharmacology
  • Plasminogen Activators / therapeutic use*
  • Recombinant Proteins / administration & dosage
  • Recombinant Proteins / pharmacology
  • Recombinant Proteins / therapeutic use
  • Time Factors
  • Urokinase-Type Plasminogen Activator / administration & dosage
  • Urokinase-Type Plasminogen Activator / pharmacology
  • Urokinase-Type Plasminogen Activator / therapeutic use*
  • Vascular Patency
  • alpha-2-Antiplasmin / analysis

Substances

  • Fibrinolytic Agents
  • Recombinant Proteins
  • alpha-2-Antiplasmin
  • Fibrinogen
  • Plasminogen
  • Plasminogen Activators
  • Urokinase-Type Plasminogen Activator