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.
MARDER VJ, ROTHBARD RL, FITZPATRICK PG, et al. 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: https://doi.org/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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