Anistreplase (APSAC)

An acylated inactive complex of streptokinase and human lysine-plasminogen. After injection, the acyl group is slowly hydrolyzed, producing an activator that converts plasminogen to plasmin, thereby initiating fibrinolysis. Its half-life is about 90 minutes compared to 5 minutes for TPA; (TISSUE PLASMINOGEN ACTIVATOR); 16 minutes for UROKINASE-TYPE PLASMINOGEN ACTIVATOR and 23 minutes for STREPTOKINASE. If treatment is initiated within 3 hours of onset of symptoms for acute myocardial infarction, the drug preserves myocardial tissue and left ventricular function and increases coronary artery patency. Bleeding complications are similar to other thrombolytic agents.

Also Known As:

Networked: 227 relevant articles (25 outcomes, 79 trials/studies)

Relationship Network

Drug Context: Research Results

Experts

1.	Chaffin, Mark: 2 articles (08/2008 - 02/2006)
2.	Pennington, Randal: 1 article (11/2006)
3.	Rosa, Linda: 1 article (11/2006)
4.	Becker-Weidman, Arthur: 1 article (11/2006)
5.	Reilly, Kathryn Miller: 1 article (11/2006)
6.	Misbach, Alan: 1 article (11/2006)
7.	Mercer, Jean: 1 article (11/2006)
8.	Lyon, Lynne: 1 article (11/2006)
9.	Donnis, Randi: 1 article (11/2006)
10.	Nichols, Todd: 1 article (02/2006)

Related Diseases

1.	Myocardial Infarction 02/01/1990 - "Thus bolus IV injection of 30 units of APSAC is both safe and effective in preserving left ventricular function when given early in the course of acute myocardial infarction." 01/01/1987 - "It is concluded that thrombolytic treatment of acute myocardial infarction with APSAC is effective and safe, as long as the standard precautions for thrombolytic treatment are respected. " 09/01/1993 - "Recovery of left ventricular function after acute myocardial infarction: efficacy of domiciliary thrombolysis in the Grampian Region Early Anistreplase Trial." 09/27/1986 - "The ease of administration and the apparent efficacy of APSAC suggest that it is suitable for use in a district hospital for patients with suspected acute myocardial infarction." 06/01/1998 - "Third trial of Thrombolysis with Eminase in Acute Myocardial Infarction."
2.	Thrombosis (Thrombus) 12/01/1990 - "SK and APSAC are most effective at achieving thrombolysis when administered early in the course of AMI; rt-PA retains its superior efficacy on the older thrombus. " 03/01/1993 - "In a second group of animals, a carotid artery thrombus was formed and lysed with administration of anisoylated plasminogen streptokinase activator complex (0.05 U.kg-1). " 06/01/1987 - "Of the patients receiving BRL 26921, five (15%) had complete, and three (9%) partial lysis of the occluding thrombus. " 03/01/1986 - "Because therapy can be completed within 2 to 4 minutes, APSAC appears to be a most suitable fibrinolytic agent for early treatment of the coronary artery thrombosis associated with acute transmural myocardial infarction." 11/01/1994 - "APSAC alone lysed the thrombus in each vessel within 17 +/- 3 minutes. "
3.	Infarction 03/01/1985 - "Intravenous BRL 26921 is highly effective in causing coronary reperfusion and may help to preserve left ventricular function when given early in the course of anterior infarction." 01/01/1994 - "The latter included post mortem examination of 35 myocardial samples from patients treated with APSAC in the acute phase of the infarction. " 10/01/1993 - "Compared with later administration in hospital, anistreplase at home resulted in a relative reduction of mortality of 49% (95% confidence interval 3.95%, 2p = 0.04), and a relative reduction of 26% in the proportion of survivors with infarction who had Q-waves (95% CI 7.44%, 2p = 0.007). " 03/01/1990 - "A significant 31% reduction in infarct size was found in the anistreplase group (33% for the anterior wall infarction subgroup [p less than 0.05] and 16% for the inferior wall infarction subgroup, NS). " 04/01/1989 - "A significant 31% reduction in infarct size was found in the APSAC group (33% for the anterior infarction subgroup [p less than 0.05] and 16% for the inferior infarction subgroup [p = NS]). "
4.	Pain (Aches) 08/01/1995 - "Administration of Anistreplase in the rural Emergency Room brought about a significant reduction of pain to needle time, a significant improvement in left ventricular function and a reduction in mortality." 03/28/1992 - "There was no significant mortality difference during days 0-35, either among all randomised patients (1455 [10.6%] SK vs 1448 [10.5%] APSAC) or among the pre-specified subset presenting within 0-6 h of pain onset and with ST elevation on the electrocardiogram in whom fibrinolytic treatment may have most to offer (861 [10.0%] SK vs 855 [9.9%] APSAC). " 09/01/1991 - "The mean time (+/- 1 SD) from onset of pain to injection of APSAC was 95 +/- 47 min and the mean estimated time gain, calculated as the time difference between the arrival of the MICU at home and the arrival of the MICU at the emergency department, was 50 +/- 17 min. In the prehospital period four patients developed ventricular fibrillation and one cardiogenic shock. " 02/01/1999 - "Prehospital thrombolysis was applied 151+/-61 minutes after the onset of pain in 170 patients (56+/-12 years, 86% men), using recombinant tissue-type plasminogen activator, streptokinase, or eminase. " 09/01/1991 - "Patients with clinically suspected AMI and with typical ECG changes presenting within 4 h after onset of pain were treated with 30 units of Anisoylated Plasminogen Streptokinase Activator Complex (APSAC, eminase) intravenously by a mobile intensive care unit (MICU). "
5.	Hemorrhage 06/01/1987 - "Improved lysis rates with fewer bleeding complications might be achieved by reducing the dose of BRL 26921. " 04/01/1992 - "There were more bleeding complications after APSAC (45% vs. 31%, p = 0.0019).(ABSTRACT TRUNCATED AT 250 WORDS)" 02/01/1991 - "Bleeding complications occurred in 12% (7/58) of treated patients in the anistreplase group vs 20.7% (13/58) in the SK group (NS). " 01/01/1987 - "Fibrinolytic activity was more pronounced in the APSAC group but there were no major bleeding problems in either group. " 09/01/1991 - "Bleeding complications requiring blood transfusion occurred in one APSAC patient and in two rt-PA patients. "

Related Drugs and Biologics

1.	Anistreplase (APSAC)
2.	Streptokinase
3.	Tissue Plasminogen Activator (Alteplase)
4.	Fibrinolytic Agents (Antithrombotic Agents)
5.	Heparin (Liquaemin)
6.	Plasminogen
7.	Urokinase-Type Plasminogen Activator (Urokinase)
8.	Fibrin
9.	streptokinase-plasminogen complex
10.	Fibrinogen (Factor I)

Related Therapies and Procedures

1.	Intravenous Infusions
2.	Intravenous Injections
3.	Thrombolytic Therapy
4.	Angioplasty (Angioplasty, Transluminal)
5.	Aftercare (After-Treatment)