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Drugs

, Volume 33, Supplement 3, pp 287–292 | Cite as

Safety and Tolerance Data from the Belgian Multicentre Study of Anisoylated Plasminogen Streptokinase Activator Complex versus Heparin in Acute Myocardial Infarction

  • Leo L. Bossaert
Section 5: Safety and Tolerance Data Comparative Non-Invasive Trial

Summary

In the European Multicentre Study (EMS), the safety and efficacy of a single 30U intravenous injection of anisoylated plasminogen streptokinase activator complex (APSAC) was studied in patients with acute myocardial infarction. The present study discusses the Belgian data on safety and tolerance from the EMS study. 87 patients were randomised to treatment with APSAC or heparin. The reperfusion rate was 60.5% (APSAC) versus 20.5% (heparin control), and reocclusion occurred in 21% of the reperfused APSAC patients. Drug-related adverse events consisted of bleeding problems (7 events in patients on APSAC and 1 event in a patient on heparin and moderate allergic reactions (12 events in 9 patients on APSAC and 1 event in a heparin patient). There was 1 drug-related death in the APSAC group (hypovolaemic shock due to central vein puncture during lytic state) which could have been avoided. 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. Bleeding and allergic-type events are infrequent, usually well tolerated and easily treated.

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References

  1. Ganz W, Geft I, Shah P, et al. Intravenous streptokinase in evolving acute myocardial infarction. American Journal of Cardiology 53: 1209–1216, 1984PubMedCrossRefGoogle Scholar
  2. Kennedy JW, Ritchie JL, Davis KB, Fritz JK. Western Washington randomized trial of intracoronary streptokinase in acute myocardial infarction. New England Journal of Medicine 309: 1477, 1983PubMedCrossRefGoogle Scholar
  3. Renkin J, Col-De Beys C, Lavenne-Pardonge E, Pintens H, Coll J. Analysis of coagulation and fibrinolysis after intravenous anisoylated plasminogen streptokinase activator complex or heparin in patients with acute myocardial infarction: a Belgian multicentre study. Drugs 33 (Suppl. 3): 253–260, 1987PubMedCrossRefGoogle Scholar
  4. Simoons ML, van den Brand C, Zwaan C, Verheugt FWA, Remue WJ, et al. Improved survival after early thrombolysis in acute myocardial infarction: a randomized trial by the inter university cardiology institute of the Netherlands. Lancet 2: 578, 1985PubMedCrossRefGoogle Scholar
  5. Taeymans Y, Materne P. Assessment of left ventricular function in a randomised study of intravenous anisoylated plasminogen steptokinase activator complex versus heparin in acute myocardial infarction: preliminary results of the European multicentre study (Belgian centres). Drugs 33 (Suppl. 3): 216–220, 1987PubMedCrossRefGoogle Scholar
  6. TIMI-Study Group. The Thrombolysis in myocardial infarction (TIMI) trial. Phase I findings. New England Journal of Medicine 312: 932, 1985Google Scholar
  7. Verstraete M, Bleifeld W, Brower RW, Charbonnier B, Collen D, et al. Double-blind randomised trial of intravenous tissue-type plasminogen activator versus placebo in acute myocardial infarction. Lancet 2: 965, 1985aPubMedCrossRefGoogle Scholar
  8. Verstraete M, Bernard R, Bory M, Brower RW, Collen D, et al. Randomised trial of intravenous recombinant tissue-type plasminogen activator versus intravenous streptokinase in acute myocardial infarction. Lancet 1: 842, 1985bPubMedCrossRefGoogle Scholar

Copyright information

© ADIS Press Limited 1987

Authors and Affiliations

  • Leo L. Bossaert
    • 1
  1. 1.Intensive CareAkademisch Ziekenhuis Antwerpen, U.I.A.EdegemBelgium

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