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French multicenter trial of anistreplase versus heparin in acute myocardial infarction

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Summary

Eighty-four patients aged less than 71 years with less than 4-hour duration acute myocardial infarction (AMI) were randomized in a multicenter study to 30 U anistreplase or heparin (single injection of 6500 IU followed by 1000 IU/hr). Early reperfusion was assessed from ECG changes (50% of sum ST decrease 2 hours postdosing) and the CK release profile (CK peak <16 hours after onset of symptoms, CK slope >10%hr). Reperfusion rates in patients meeting at least two criteria of reperfusion were 62.5% on anistreplase versus 27.5% on heparin. On delayed angiogram (13.7±3.4 days), patency rates were 66% with anistreplase versus 47% (NS) with heparin in 76 patients. Global LVF was similar in both groups. With anistreplase, the mean lowest fibrinogen level was 0.43±0.55 g/l, plasminogen was 20±9%, and the highest F.D.P. was 1447±548 μg/ml. All values recovered by hour 48. In-hospital and 1-year follow-up mortality was 7.2% (three patients) with anistreplase versus 10.2% (four patients) with heparin. Bleeding occurred in 9.7% and 5.1% of the patients (NS), respectively. No intracranial hemorrhage occurred. Thus, with combined clinical criteria or reperfusion, anistreplase is twice as efficient as heparin, has a good tolerance, and is easy to use as a single injection.

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Author information

Authors and Affiliations

  1. Service de Cardiologie, Centre Hospitalier Gilles de Corbeil, 59 bd Henri Dunand, 91108, Corbeil-Essonnes, France

    H. Lardoux, Y. Louvard, D. de Vernejoul, C. Picot, M. Baudet, M. Hiltgen, M. Houplon, J. Ponsonnaille, M. Richard, R. Luccioni, R. Rocher, G. Hanania, P. Gaudeul, A. Cribier & B. Letac

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  1. H. Lardoux
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  2. Y. Louvard
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  3. D. de Vernejoul
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  4. C. Picot
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  5. M. Baudet
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  7. M. Houplon
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  10. R. Luccioni
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  11. R. Rocher
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Additional information

Anistreplase is the generic name ofEminase, a registered trademark of Beecham Pharmaceuticals.

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Lardoux, H., Louvard, Y., de Vernejoul, D. et al. French multicenter trial of anistreplase versus heparin in acute myocardial infarction. Cardiovasc Drug Ther 4, 1337–1344 (1990). https://doi.org/10.1007/BF02018261

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