Anisoylated Plasminogen Streptokinase Activator Complex versus Placebo

Drugs - Tập 33 - Trang 261-267 - 2012
D. G. Julian1, L. S. Borthwick2, D. Reid1, K. P. Jennings3, R. J. Wainwright4, J. C. Rodger5, D. Wood6, W. S. Phillips7
1Freeman Hospital, Newcastle upon Tyne, UK
2Lister Hospital, Stevenage, UK
3Aberdeen Royal Infirmary, Aberdeen, Scotland
4Brook Hospital, London, UK
5Monklands District Hospital, Airdrie, Canada
6Royal South Hants Hospital, Southampton, UK
7Beecham Pharmaceuticals UK Division, Brentford, England

Tóm tắt

90 patients were enrolled into this preliminary multicentre study of the efficacy and safety of 30 units intravenous anisoylated plasminogen streptokinase activator complex (APSAC) compared with placebo in patients with acute myocardial infarction. 45 patients received APSAC and 45 placebo; the groups were similar for age, weight and site of infarction. There were significantly more women treated with APSAC (p < 0.02). The mean time to treatment was 3.3 hours after symptoms of myocardial infarction for APSAC and 3 hours for placebo. The 30-day mortality was 7 patients in the placebo group and 1 in the APSAC group (p = 0.058). Adverse events were generally minor and were of similar overall frequency in both groups. There were more haemorrhagic events with APSAC, from which all patients recovered, and more cardiovascular events with placebo including 2 deaths from cardiogenic shock. APSAC showed a trend towards a reduction in 30-day mortality. Experience from this study has led to the initiation of the APSAC in myocardial infarction multicentre mortality study (AIMS).

Tài liệu tham khảo

Been M, de Bono DP, Muir AL, Boulton FE, Fears R, et al. Clinical effects and kinetic properties of intravenous APSAC (BRL 26921) in acute myocardial infarction. International Journal of Cardiology 11: 53–61, 1986 Been M, de Bono DP, Muir AL, Boulton FE, Hillis WS, et al. Coronary thrombolysis with intravenous anisoylated plasminogen streptokinase complex BRL 26921. British Heart Journal 53: 253–259, 1985 Buchalter MB, Bourke JP, Jennings K, Adams PC, Kenmure ACF, et al. The effect of thrombolytic therapy with anisoylated plasminogen streptokinase activator complex on the indicators of myocardial salvage. Drugs 33 (Suppl. 3): 208–214, 1987 Constantini C, Corday E, Lang TW, et al. Revascularisation after 3 hours of coronary arterial occlusion: effects on regional cardiac metabolic function and infarct size. American Journal of Cardiology 36: 252–284, 1975 Davies GJ, Chierchia S, Maseri A. Prevention of myocardial infarction by very early treatment with intracoronary streptokinase: some clinical observations. New England Journal of Medicine 311: 1488–1492, 1984 GISSI — Gruppo Italiano per lo studio della streptochinasi nell’infarto miocardico. Effectiveness of intravenous thrombolytic treatment in acute myocardial infarction. Lancet 1: 397–402, 1986 Ikram S, Lewis S, Bucknall C, Sram I, Thomas N, et al. Treatment of acute myocardial infarction with anisoylated plasminogen streptokinase activator complex. British Medical Journal 293: 786–789, 1986 Kennedy JW, Ritchie JL, Davis KB, Fritz JK. Western Washington randomised trial of intracoronary streptokinase in acute myocardial infarction. New England Journal of Medicine 309: 1477–1482, 1983 Schröder R, Biamino G, Leirner EV, et al. Intravenous short-term infusion of streptokinase in acute myocardial infarction. Circulation 67: 536–548, 1983 Simoons ML, Serruys PW, Brand M van den, et al. Improved survival after early thrombolysis in acute myocardial infarction. Lancet 2: 578–582, 1985 Verstraete M. Intravenous administration of a thrombolytic agent is the only realistic therapeutic approach in evolving myocardial infarction. European Heart Journal 6: 586–593, 1985 Yusuf S, Collins R, Peto R, Furberg C, Stampfer MJ, et al. Intravenous and intracoronary fibrinolytic therapy in acute myocardial infarction: overview of results on mortality, reinfarction and side-effects from 33 randomised controlled trials. European Heart Journal 6: 556–585, 1985