Systemic effects of BRL 26921 during thrombolytic treatment of acute myocardial infarction

High-Dose Systemic Streptokinase and Acylated Streptokinase-Plasminogen Complex (BRL 26921) in Acute Myocardial Infarction: Alterations of the Fibrinolytic System and Clearance of Fibrinolytic Activity

“…In pa tients with AMI, the systemic fibrinogenoly sis after BRL 26921 seemed to be doserelated when the patient's pretreatment SK resistance was taken into account [12]. The reperfusion rate in this trial with a mean dose of 11.6 mg BRL 26921 was markedly inferior when compared with the results of a study by Hoffmann et al [13] and our own study, both with 30 mg BRL 26921. No rele vant differences in the decrease of fibrino gen, plasminogen and a^-antiplasmin were found in the four subgroups of our studies.…”

“…The high reperfusion rates, especially in the second study, are in accordance with the results of Ganz et al [7] who found evidence for early reperfusion in 78 of 81 consecutive patients using a comparable treatment regi men (750,000 -1,500,000 U SK in 15-30 min). Hoffmann et al [13], using the same dose of BRL 26921, found reperfusion of the coronary vessels in 11 of 13 patients within 5-60 min. However, in studies with immediate coronary angiography, the rate of patency ranged from 44 to 62%, when 0.7-1.5 X 106 U SK were given within 44-85 min [3,4,10].…”

“…Current attempts to improve the efficacy of thrombolytic therapy include the use of very high doses of SK [6,7], bolus injections of SK [8], or infusions of more fibrin-specific [9][10][11] and longer-acting agents [12,13]. We report on the results of two consecutive stud ies utilizing high-dose bolus injections of either SK or acylated SK-plasminogen com plex.…”

Acyl Enzymes for Thrombolytic Therapy

“…Marder et al 36 Hillis et al 41 Hornung et al 42 Been et al 34,43 Kasper et al 44 Hoffmann et al 45 Doenecke et al 46 Been at venipuncture sites, 4 hemorrhage has been un common in APSAC-treated cases of myocardial in farction. In elderly patients with advanced peri pheral arterial disease, APSAC therapy has been associated with hemorrhagic complications.…”

Thrombolytic Treatment in Acute Myocardial Infarction

“…Its association with plasminogen increases its affinity for fibrin. 70,71 A dozen clinical trials have now been reported. They all encompass small groups of patients, never exceeding 50.…”