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Results of high dose intravenous urokinase for acute myocardial infarction.

Publication ,  Journal Article
Wall, TC; Phillips, HR; Stack, RS; Mantell, S; Aronson, L; Boswick, J; Sigmon, K; DiMeo, M; Chaplin, D; Whitcomb, D
Published in: Am J Cardiol
January 15, 1990

To determine the outcome of patients after treatment with high-dose intravenous urokinase (3 million U) 102 patients were prospectively evaluated in the setting of acute myocardial infarction. The first 61 patients received intravenous urokinase as a continuous infusion and the last 41 patients were treated with an initial 1.5 million U intravenous bolus. Sixty-two percent of all patients had patent infarct-related arteries by the time of immediate angiography (median time 2.2 hours), which was performed in all patients. There was no significant difference in patency rates between patients treated with or without an initial intravenous bolus. Twenty-eight (28%) patients developed clinical evidence of recurrent ischemia (death, reocclusion, emergency angioplasty, urgent bypass surgery) during hospitalization, whereas only 7 (7%) developed angiographically documented reocclusion. Of 28 patients who failed to achieve successful reperfusion at the time of immediate catheterization, rescue angioplasty was technically successful in establishing reperfusion in all but 1 patient. No significant improvement in median global left ventricular function was seen between immediate (48%) and follow-up catheterization (48%). Significant bleeding complications were unusual except in 1 patient who experienced an intracranial hemorrhage. Eight (8%) patients died during hospitalization. Therefore, the use of high-dose intravenous urokinase in patients with acute myocardial infarction is associated with a 62% patency rate, a low incidence of reocclusion and bleeding complications and a high technical success rate with rescue angioplasty at the time of immediate catheterization.(ABSTRACT TRUNCATED AT 250 WORDS)

Duke Scholars

Published In

Am J Cardiol

DOI

ISSN

0002-9149

Publication Date

January 15, 1990

Volume

65

Issue

3

Start / End Page

124 / 131

Location

United States

Related Subject Headings

  • Vascular Patency
  • Urokinase-Type Plasminogen Activator
  • Recurrence
  • Prospective Studies
  • Myocardial Infarction
  • Middle Aged
  • Infusions, Intravenous
  • Humans
  • Hemorrhage
  • Heart Ventricles
 

Citation

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Wall, T. C., Phillips, H. R., Stack, R. S., Mantell, S., Aronson, L., Boswick, J., … Whitcomb, D. (1990). Results of high dose intravenous urokinase for acute myocardial infarction. Am J Cardiol, 65(3), 124–131. https://doi.org/10.1016/0002-9149(90)90072-9
Wall, T. C., H. R. Phillips, R. S. Stack, S. Mantell, L. Aronson, J. Boswick, K. Sigmon, M. DiMeo, D. Chaplin, and D. Whitcomb. “Results of high dose intravenous urokinase for acute myocardial infarction.Am J Cardiol 65, no. 3 (January 15, 1990): 124–31. https://doi.org/10.1016/0002-9149(90)90072-9.
Wall TC, Phillips HR, Stack RS, Mantell S, Aronson L, Boswick J, et al. Results of high dose intravenous urokinase for acute myocardial infarction. Am J Cardiol. 1990 Jan 15;65(3):124–31.
Wall, T. C., et al. “Results of high dose intravenous urokinase for acute myocardial infarction.Am J Cardiol, vol. 65, no. 3, Jan. 1990, pp. 124–31. Pubmed, doi:10.1016/0002-9149(90)90072-9.
Wall TC, Phillips HR, Stack RS, Mantell S, Aronson L, Boswick J, Sigmon K, DiMeo M, Chaplin D, Whitcomb D. Results of high dose intravenous urokinase for acute myocardial infarction. Am J Cardiol. 1990 Jan 15;65(3):124–131.
Journal cover image

Published In

Am J Cardiol

DOI

ISSN

0002-9149

Publication Date

January 15, 1990

Volume

65

Issue

3

Start / End Page

124 / 131

Location

United States

Related Subject Headings

  • Vascular Patency
  • Urokinase-Type Plasminogen Activator
  • Recurrence
  • Prospective Studies
  • Myocardial Infarction
  • Middle Aged
  • Infusions, Intravenous
  • Humans
  • Hemorrhage
  • Heart Ventricles