Efficacy of intracoronary and intravenous urokinase in acute myocardial infarction.

The efficacy of intracoronary and intravenous urokinase was studied in 83 patients with acute evolving myocardial infarction. Urokinase was administered intracoronary in 48 patients with a success rate of 89% obtained after 47 +/- 32 minutes of infusion of a dose of 255.000 +/- 224.000 IU. In-hospital mortality in this group of patients was 10%. Severe arrhythmias were observed in 33% of the patients and the reocclusion rate at the re-study was 16%. Intravenous urokinase was administered as 200.000 IU bolus followed by 1.220.000 IU infusion in 21 patients. Angiography performed in this group of patients 48 hours after therapy showed a patency rate of 66%. A single intravenous bolus of 500.000 IU of urokinase was administered to 14 patients. At angiography all patients but one were found reperfused. The value of intravenous low-dose bolus injection of urokinase in acute myocardial infarction needs hower to be assessed with a properly designed clinical trial.