Coronary Thrombolysis with Intravenous Urokinase in Acute Myocardial Infarction

ABSTRACT

Recent studies showed effective early recannalization of infarct-related artery achieved by intravanous urokinase, but dosage of urokinase is still arbitary. Thirty-five patients with acute trasmural myocardial infarction were treated with intraveous urokinase from April 1984 to October 1988. The incidence of coronary thrombolysis, left ventricula function and effect on fibrinolytic system were investigated. Inital 18 patients recieved 0.5 to 2.0 million unitis of urokinase and remaining 17 patients received 3 million units of urokinase intravenously for 1 hour. Thirteen of 17 patients(76.4%) with 3 million units but only four of 18 patients(22.2%) with 0.5 to 2.0 million units showed patent infarct-related coronary artery. Left ventricular function was significantly better in patients with patent infarct-related coronary artery, and the difference was marked in anterior myocardial infarction. There were three local bleeding at puncture site in 3 million units group, one of which required transfusion. Thus, intravenous infusion of 3 million units of urokinase provide rapid reperfusion of infarct-related coronary arterty and myocardial salvage is more lkiely to occur.