Efficacy and safety of a new streptokinase regimen with enoxaparin in acute myocardial infarction
| Autor: | Petre Capraru, Cristina Teodorescu, Manuela Guran, Oana Istratescu, Maria Dorobantu, Monica Dan, Aurelia Bumbu, Gabriel Tatu-Chitoiu, Alexandrina Tatu-Chitoiu |
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| Rok vydání: | 2004 |
| Předmět: |
Male
medicine.drug_class medicine.medical_treatment Streptokinase Myocardial Infarction Low molecular weight heparin Myocardial Reperfusion medicine Humans Myocardial infarction Enoxaparin Aged business.industry Heparin Anticoagulant Hematology Thrombolysis Middle Aged medicine.disease Survival Rate Regimen Anesthesia Drug Therapy Combination Female Hypotension Cardiology and Cardiovascular Medicine business Enoxaparin sodium medicine.drug |
| Zdroj: | Journal of thrombosis and thrombolysis. 15(3) |
| ISSN: | 0929-5305 |
| Popis: | To compare a new streptokinase regimen combined with either enoxaparin or unfractionated heparin (UFH) and the traditional streptokinase regimen combined with UFH in patients with acute myocardial infarction (AMI).412 patients (75 years), hospitalized within 6 hours of the onset of chest pain, were allocated thrombolytic therapy by the treating physician: streptokinase 0.75 MU/10 minutes, repeated if no coronary reperfusion after one dose, plus enoxaparin 40 mg intravenously followed by 1 mg/kg bodyweight subcutaneously at 12-hour intervals for 5-7 days (n = 102); the same streptokinase regimen plus UFH 1000 IU/60 minutes intravenously for 48-72 hours ( n = 106); or streptokinase 1.5 MU/60 minutes plus the same UFH regimen (n = 204). All patients received 250-325 mg aspirin/day. Coronary reperfusion rates, 30-day mortality and hemorrhagic complications were recorded.Coronary reperfusion rates with 0.75 streptokinase + enoxaparin (78.4%) and 0.75 streptokinase + UFH (74.5%) were significantly higher than those with 1.5 streptokinase + UFH (62.2%), but there was no significant difference between the groups receiving the new regimen. Overall 30-day mortality (6.3%) was significantly lower than with 1.5 streptokinase + UFH (12.7%) ( p = 0.037). The incidence of major and minor hemorrhagic events was similar in all groups.The accelerated streptokinase regimen was well tolerated and resulted in a significantly higher coronary reperfusion rate and significantly lower mortality compared with the traditional regimen. The 0.75 streptokinase + enoxaparin combination was at least as efficacious as the 0.75 streptokinase + UFH combination and is preferred because of its ease of administration and predictable anticoagulant effect. |
| Databáze: | OpenAIRE |
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