Open AccessEffects on infarct size and left ventricular function of early intravenous injection of anistreplase in acute myocardial infarction
Author(s) -
Bassand J. P.,
Bernard Y.,
Lusson J. R.,
Machecourt J.,
Cassagnes J.,
Borel E.
Publication year - 1990
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960131310
Subject(s) - medicine , myocardial infarction , cardiology , ventricular function , infarction , electrocardiography in myocardial infarction , anesthesia
Abstract A total of 231 patients suffering from a first acute myocardial infarction were randomly allocated within 4 hours following the onset of symptoms either to anistreplase or anisoylated plasminogen streptokinase activator complex (APSAC), 30 U over 5 minutes, or to conventional heparin therapy, 5000IU in bolus injection. Heparin was reintroduced in both groups 4 h after initial therapy at a dosage of 500 IU/kg per day. A total of 112 patients received anistreplase and 119 received heparin within a mean period of 188 ±62 min following the onset of symptoms. Infarct size was estimated from single photon emission computerized tomography and expressed in percentage of the total myocardial volume. The patency rate of the infarct‐related artery was 77% in the anistreplase group and 36% in the heparin group (p<0.001). Left ventricular ejection fraction determined from contrast angiography was significantly higher in the anistreplase group than in the heparin group (6 absolute percentage point difference). A significant 31 % reduction in infarct size was found in the anistreplase group (33% for the anterior wall infarction subgroup [p<0.05] and 16% for the inferior wall infarction subgroup, NS). A close inverse relation was found between the values of left ventricular ejection fraction and infarct size (r= ‐.73, p<0.01). in conclusion, early infusion of anistreplase in acute myocardial infarction produced a high early patency rate, a significant limitation of infarct size, and a significant preservation of left ventricular systolic function, mainly in the anterior wall infarctions.