ABSTRACT
PURPOSE: Analysis of the first 20 patients with acute myocardial infarction (AMI) who were treated with intravenous APSAC. METHODS: Twenty patients with AMI less than 6 hours of duration of symptoms were treated with IV APSAC bolus of 30 mg. Seventeen were males, ages ranging between 40 and 73 (mean 54) years. The first angiographic study was performed in 90 minutes and 5-7 days after drug administration. RESULTS: In the angiographic study performed at 90 minutes the infarct--related artery were left anterior descending (LAD) in 7 patients (35%), right coronary artery (RCA) in 9 (45%) and left circumflex (LCX) in 4 (20%). In 14 (70%) of the patients had patent infarct-related artery and the mean of left ventricular ejection fraction (LVEF) was 0.49 +/- 0.15. In six non recanalized patients the mean LVEF was 0.40 +/- 0.14. No complications were observed, and in the second angiographic study one patient showed reocclusion of the infarct-related artery. CONCLUSION: Because of easy application (IV bolus), no complication and high rate of early recanalization, IV APSAC seems to be an efficient thrombolytic agent in the treatment of patients with AMI.
Subject(s)
Anistreplase/therapeutic use , Myocardial Infarction/drug therapy , Thrombolytic Therapy , Adult , Aged , Anistreplase/administration & dosage , Emergencies , Female , Humans , Injections, Intravenous , Male , Middle AgedABSTRACT
PURPOSE: To compare the results of intravenous thrombolytic therapy with streptokinase (SK), with those of the recombinant human tissue-type plasminogen activator (r-TPA), in acute myocardial infarction (AMI). MATERIAL AND METHODS: One hundred patients with AMI of less than 6 hours duration were randomized in two groups: 50 patients were allocated to 1.200.000 IU of SK (Group SK) and 50 patients received 100 mg of r-TPA over 180 minutes. The two groups were similar respecting age, sex, location and previous infarction. The angiographic study was performed 48 h after the thrombolytic therapy. RESULTS: In the angiographic study, 85% of the Group SK vs 66% of Group r-TPA had patient infarct-related vessel (p = 0.025). Reocclusion was 6.6% in Group SK vs 19% in Group r-TPA and hospital mortality was similar in the two groups. CONCLUSION: In the late angiographic evaluation (48 h), the frequency of coronary patency was found to be higher after intravenous SK than after intravenous r-TPA.
Subject(s)
Myocardial Infarction/drug therapy , Streptokinase/therapeutic use , Thrombolytic Therapy , Tissue Plasminogen Activator/therapeutic use , Blood Pressure/drug effects , Female , Humans , Male , Prospective Studies , Random Allocation , Stroke Volume/drug effectsABSTRACT
A 49 year-old woman with acute pulmonary thromboembolism and severe hemodynamic impairment was successfully treated with tissue-type plasminogen activator (r-TPA). She did not have previous pulmonary or cardiac diseases. Thirty days after immobilization of the right ankle, she had a sudden onset of dyspnea, epigastrial pain and syncope. As heparin therapy was unsuccessful, 90 mg of IV r-TPA was administered. There was rapid clinical and hemodynamic improvement of her condition. Pulmonary scanning one week later was normal and she was discharged without symptoms 12 days after the acute episode.
