HOMEPRODUCTSSERVICESCOMPANYCONTACTFAQResearchDictionaryPharmaMobileSign Up FREE or Login

Sequential combination thrombolytic therapy for acute myocardial infarction: results of the Pro-Urokinase and t-PA Enhancement of Thrombolysis (PATENT) Trial.

AbstractOBJECTIVES:
The present study was designed to test the efficacy and safety of a sequential combination of recombinant tissue-type plasminogen activator (rt-PA) and pro-urokinase in patients with acute myocardial infarction.
BACKGROUND:
Efforts continue to identify a thrombolytic regimen that induces rapid, complete and sustained coronary artery patency in acute myocardial infarction. The two endogenous plasminogen activators rt-PA and pro-urokinase have been shown experimentally to induce fibrinolysis by sequential and complementary mechanisms. As a result, certain combinations of these activators have been found to be synergistic in vitro and in vivo.
METHODS:
In a multicenter observational study with core facilities for angiographic and laboratory analysis, 101 patients with acute myocardial infarction were enrolled and given a low dose bolus of rt-PA (5 to 10 mg) followed by a 90-min infusion of pro-urokinase (40 mg/h). All patients received intravenous heparin and oral aspirin. Coronary angiography was performed in all patients at 90 min.
RESULTS:
Angiography at 90 min showed the infarct-related artery to be patent (Thrombolysis in Myocardial Infarction [TIMI] grade 2 or 3 flow) in 77% of patients, and 60% achieved TIMI grade 3 flow. At one center, angiography was repeated at 24 h to detect a possible reocclusion. All 28 patients with a patent infarct-related artery at 90 min had patency at 24 h (82% achieved TIMI grade 3 flow). Treatment was well tolerated, with bleeding complications essentially confined to arterial puncture site hematomas. There was only one in-hospital death.
CONCLUSIONS:
A sequential combination of low dose rt-PA and reduced-dose pro-urokinase produced a high TIMI 3 patency rate, was well tolerated and was associated with a low reocclusion rate.
AuthorsS W Zarich, G J Kowalchuk, W D Weaver, J Loscalzo, M Sassower, K Manzo, C Byrnes, J E Muller, V Gurewich
JournalJournal of the American College of Cardiology (J Am Coll Cardiol) Vol. 26 Issue 2 Pg. 374-9 (Aug 1995) ISSN: 0735-1097 [Print] UNITED STATES
PMID7608437 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
Chemical References
  • Enzyme Precursors
  • Fibrinolytic Agents
  • Recombinant Proteins
  • saruplase
  • Tissue Plasminogen Activator
  • Urokinase-Type Plasminogen Activator
Topics
  • Adult
  • Aged
  • Confounding Factors (Epidemiology)
  • Coronary Angiography
  • Enzyme Precursors (therapeutic use)
  • Female
  • Fibrinolytic Agents (therapeutic use)
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction (drug therapy, radiography)
  • Recombinant Proteins (therapeutic use)
  • Thrombolytic Therapy (adverse effects, methods)
  • Time Factors
  • Tissue Plasminogen Activator (therapeutic use)
  • Treatment Outcome
  • Urokinase-Type Plasminogen Activator (therapeutic use)
  • Vascular Patency (drug effects)

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research network!


Choose Username:
Email:
Password:
Verify Password: