[Thrombolytic effect of a moderate dose of urokinase in acute myocardial infarction].

UNLABELLED

It appears that Chinese patients had more bleeding complications during anticoagulative and thrombolytic therapies than western populations. To determine the effect of a moderate dosage of urokinase for Chinese patients with evolving acute myocardial infarction (AMI), we studied 17 patients with AMI. The patients were divided into 2 groups: Urokinase group (UG) and control group (CG). Seven patients in UG, having AMI 5.1 +/- 1.3 hours after the onset received intravenous urokinase 250,000-450,000 units within 30 minutes and then were treated with heparin. Ten patients in CG, having AMI 12.1 +/- 10.1 hours after the onset received conventional therapy as well as heparin. The successful reperfusion of coronary artery was assessed noninvasively using peak CPK level less than 18 hours and elevated ST segment normalization within 24 hours as the criteria.

RESULTS

Successful reperfusion was found in 5 of 7 patients in UG and in only 1 of 10 patients in CG (P less than 0.05). No gastrointestinal and cerebrovascular bleeding or other major bleeding complications were observed in UG, while 1 of 10 patients in CG had gastric bleeding requiring transfusion. The mortality during 2 months of hospitalization was 2/10 (20%) in CG, but no patient in UG died during 2 months of hospital stay. The results of the study suggest that moderate dosage of urokinase could achieve reperfusion in majority of Chinese patients with AMI and may have less bleeding complications. However, randomized and large-group patient studies are needed to confirm the presented results.