[Study of new thrombolytic agents in myocardial infarction: a multicenter randomized trial (APSAC versus rt-PA)].

Abstract

A hundred and eighty three patients with a primary myocardial infarction less than 4 hours old were included in a double blind trial versus placebo comparing an isolated plasminogen streptokinase activator complex (APSAC: 30 mu in 5 mn) and tissue type plasminogen activator (rt PA: 10 mg bolus followed by 90 mg in 130 mn). Clinical evolution, side effects, patency of the artery responsible for infarction, left ventricular contractile function (contrast angiography on the 7th day and angioscintigraphy on the 21st day) and infarct size were studied. The two groups were comparable in age (54 +/- 11 years), delay in randomisation (170 +/- 50 mn), infarct site and severity of cardiac failure. There was no significant difference in hospital mortality (7 in the rt PA group and 5 in the APSAC group) or in adverse effects (haemorrhage: rt PA: 9 patients, APSAC: 11 patients). The patency was 72% in the APSAC and 76% in the rt PA group. Left ventricular function and infarct size were comparable in the two groups: angiographic EF (0.50 +/- 0.1 in the APSAC and 0.52 +/- 0.1 in the rt PA group: NS); asynergic score (11.3 +/- 1.7 in the APSAC and 10.5 +/- 1.8 in the rt PA group: NS); infarct size (10.9 +/- 8.0 in the APSAC and 9.4 +/- 7.2 in the rt PA group: NS). This trial shows that these two thrombolytic agents have the same efficacy. The authors recommend adaptation of the dosage of rt PA to body weight.

• Authors: J Cassagnes, J Machecourt, J P Bassand, J R Lusson, J E Wolf, T Anguenot, J Maublant, D Fagret, J C Cardot
• Journal: Archives des maladies du coeur et des vaisseaux (Arch Mal Coeur Vaiss) Vol. 85 Issue 11 Pg. 1593-9 (Nov 1992) ISSN: 0003-9683 [Print] France
• Vernacular Title: Etude des nouveaux thrombolytiques dans l'infarctus du myocarde (ENTIM): essai multicentrique randomisé (APSAC versus rt-PA).
• PMID: 1300957 (Publication Type: Clinical Trial, Comparative Study, English Abstract, Journal Article, Multicenter Study, Randomized Controlled Trial)

Chemical References

• Anistreplase
• Tissue Plasminogen Activator

Topics

• Adult
• Aged
• Anistreplase (therapeutic use)
• Coronary Angiography
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Myocardial Infarction (drug therapy)
• Thrombolytic Therapy
• Tissue Plasminogen Activator (therapeutic use)