HTUPA as a new thrombolytic agent for acute myocardial infarction: A multicenter,randomized study |
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Authors: | Yingxian Sun Xingli Liu Liang Guo Wenyue Pang Xiaofan Guo Zhaoqing Sun Zhanquan Li Xiaoying Cui Hui Li Guizhou Tao Lanfeng Wang Changyong Zhou Ying Liu Hongwei Shan Manqing Wang Mingxin Liu Jia Li Lei Yin Dayi Hu |
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Affiliation: | 1. Department of Cardiology, the First Hospital of China Medical University, Shenyang, People''s Republic of China;2. Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, People''s Republic of China;3. Department of Cardiology, Liaoning Provincial Hospital, Shenyang, People''s Republic of China;4. Department of Cardiology, Affiliated Hospital of Inner Mongolia University, Hohhot, People''s Republic of China;5. Department of Cardiology, The General Hospital of Daqing Oil Field, Daqing, People''s Republic of China;6. Department of Cardiology, Affiliated Hospital of Liaoning Medical College, Jinzhou, People''s Republic of China;g Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin, People''s Republic of China;h Department of Cardiology, Affiliated Hospital of Qingdao University School of Medicine, Qingdao, People''s Republic of China;i Heart Center, Peking University People''s Hospital, Beijing, People''s Republic of China |
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Abstract: | BackgroundIt is necessary to develop a new thrombolytic agent which can be used by a single bolus at first aid sites to decrease the time to reperfusion in clinical practice. HTUPA, a genetically engineered new thrombolytic with a longer half-life, is well qualified. We aim to compare the thrombolytic efficacy and safety of human tissue urokinase type plasminogen activator (HTUPA) to recombinant tissue plasminogen activator (rt-PA) in Chinese patients with acute myocardial infarction (AMI).MethodsAMI patients (n = 221) were randomized to rt-PA (a standard protocol) or HTUPA (25 mg bolus) treatment groups. All patients also received oral aspirin and intravenous heparin. Coronary angiography was performed 90 min after therapy initiation to determine infarct-related coronary artery (IRA) patency. Clinical outcomes and changes of clotting variables, heart rate, blood pressure, left ventricular ejection fraction (LVEF), and electrocardiogram were evaluated.ResultsPatent IRA [thrombolysis in myocardial infarction (TIMI) grade 2 or 3] was observed in 77% of HTUPA-treated patients, compared to 76% of rt-PA-treated patients (P = 0.76). TIMI grade 3 patency rates were 52% and 44% in the HTUPA and rt-PA groups, respectively (P = 0.37). The total patency rate was 77% (86/111 patients) in the HTUPA group and 73% (80/110 patients) in the rt-PA group (P = 0.41). Adverse events were infrequent in both groups, and no significant differences were detected in mortality, re-occlusion rate, revascularization rate, adverse effects, clotting index, LVEF, or electrocardiogram between the two groups.ConclusionsIntravenous HTUPA had a safe and efficacious profile as good as rt-PA in patients with AMI. |
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Keywords: | HTUPA rt-PA Acute myocardial infarction Patency Thrombolysis |
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