French multicenter trial of anistreplase versus heparin in acute myocardial infarction

摘要: Eighty-four patients aged less than 71 years with 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% sum ST decrease 2 hours postdosing) and the CK release profile (CK peak 10%hr). Reperfusion rates meeting at least two criteria 62.5% on versus 27.5% heparin. On delayed angiogram (13.7±3.4 days), patency 66% 47% (NS) 76 patients. Global LVF similar both groups. With anistreplase, mean lowest fibrinogen level 0.43±0.55 g/l, plasminogen 20±9%, highest F.D.P. 1447±548 μg/ml. All values recovered hour 48. In-hospital 1-year follow-up mortality 7.2% (three patients) 10.2% (four Bleeding occurred 9.7% 5.1% (NS), respectively. No intracranial hemorrhage occurred. Thus, combined clinical reperfusion, is twice as efficient heparin, has good tolerance, easy use single injection.