VICTOR J. MARDER, M.D.; ROBERT L. ROTHBARD, M.D.; PATRICIA G. FITZPATRICK, M.D.; CHARLES W. FRANCIS, M.D.
The ability of anisoylated plasminogen: streptokinase activator complex (APSAC) to induce coronary artery reperfusion after bolus intravenous injection (2 to 4 minutes) was assessed in 29 patients with acute transmural myocardial infarction and complete coronary artery occlusion. A 5-mg dose resulted in reperfusion in 3 of 14 patients (21%); a 5-mg plus 10-mg regimen was successful in 3 of 7 (43%); and a 30-mg dose induced reperfusion in 9 of 15 (60%). Rethrombosis occurred in only 1 of 15 patients (7%) who received 30 mg, as determined by repeat angiography at 24 hours. The mean interval after injection until reperfusion was 35 minutes with the 30-mg dose, and bleeding occurred at the femoral artery catheterization site in only 3 of 15 patients (20%). Intracoronary streptokinase therapy achieved reperfusion in only 2 of the 6 patients in whom the 30-mg dose failed, indicating that this dose of APSAC was sufficient by itself in 9 of 11 (83%) successfully treated patients. Because therapy can be completed within 2 to 4 minutes, APSAC appears to be a most suitable fibrinolytic agent for early treatment of the coronary artery thrombosis associated with acute transmural myocardial infarction.
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MARDER VJ, ROTHBARD RL, FITZPATRICK PG, FRANCIS CW. Rapid Lysis of Coronary Artery Thrombi with Anisoylated Plasminogen: Streptokinase Activator Complex: Treatment by Bolus Intravenous Injection. Ann Intern Med. 1986;104:304–310. doi: 10.7326/0003-4819-104-3-304
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Published: Ann Intern Med. 1986;104(3):304-310.
Cardiology, Coronary Heart Disease.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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