[The dose of intracoronary urokinase infusion in acute myocardial infarct].

In 11 patients with acute myocardial infarction (mean age 52 +/- 6 years) coronary angiography was performed 4.5 +/- 3.6 h after the onset of symptoms. The infarct-related artery was in 7 cases the right coronary artery and in 4 cases the left anterior descending branch of the left coronary artery. The infarct-related artery showed total or subtotal occlusion and no perfusion (Thrombolysis in Myocardial Infarction trial (TIMI) grade 0 or 1). In 7 cases Urokinase was infused intracoronarily at a dosage of 250,000 IU over 30 min, but in only 1 case partial reperfusion was achieved. However, all patients treated with 500,000 IU Urokinase over 30 min or 1 Mill IU over 60 min had successful reperfusion (TIMI grade 2 or 3). Thus, it appears that 500,000 IU up to 1 Mill IU of Urokinase over a period of 30 to 60 min is adequate for intracoronary thrombolysis in patients with acute myocardial infarction.