Clinical effects and kinetic properties of intravenous APSAC--anisoylated plasminogen-streptokinase activator complex (BRL 26921) in acute myocardial infarction |
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| Authors: | M Been D P de Bono A L Muir F E Boulton R Fears R Standring H Ferres |
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| Affiliation: | 1. Instituto de Biomedicina de Sevilla, IBIS (Universidad de Sevilla, HUVR, Junta de Andalucía, CSIC), Sevilla, Spain;2. Department of Clinical Biochemistry, Virgen del Rocío University Hospital, Seville, Spain;3. Departamento de Bioquímica Médica y Biología Molecular e Inmunología, Facultad de Medicina, Universidad de Sevilla, Spain;4. Division of Geriatric Medicine, Hospital Virgen del Valle, Complejo Hospitalario de Toledo, Toledo, Spain;5. Servicio de Geriatría y Fundación para la Investigación Biomédica, Hospital Universitario de Getafe Madrid, Spain;1. Department of Cardiology, University Hospital of Toulouse, Toulouse, France;2. UMR1027, INSERM—Toulouse University III, Toulouse, France;3. Department of Epidemiology, University Hospital of Toulouse, Toulouse, France;4. Department of Gerontology, University Hospital of Toulouse, Toulouse, France |
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| Abstract: | Fifty patients with a first myocardial infarction presenting within 4 hours of the onset of symptoms were treated with intravenous anisoylated plasminogen-streptokinase activator complex (APSAC-BRL 26921). Vessel patency with good flow was documented in 88%. The left ventricular ejection fraction declined with the duration of symptoms before treatment (r = -0.53, P less than 0.001). The correlation persisted for the group with anterior infarction (r = -0.46, P less than 0.05) where the mean left ventricular ejection fraction prior to discharge from hospital was 36 +/- 9% compared to 49 +/- 7% for the group with inferior infarction. Reinfarction developed in 12% and mortality at 6 months for the whole group was 6%. A degree of systemic fibrinolysis did occur with a fall in mean plasma fibrinogen from 3.20 g/l to 1.08 g/l. A pharmacokinetic study was performed in six patients demonstrating a clearance half-life of fibrinolytic activity of 87.5 +/- 5.0 min. APSAC is an effective intravenous thrombolytic agent with a relatively long half-life of fibrinolytic activity. |
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