Multicenter clinical trial of thrombolytic therapy in 1,406 patients with acute myocardial infarction. Collaborative Group of Clinical Trial for Urokinase Therapy.

OBJECTIVE

To investigate the clinical efficacy and safety of intravenous thrombolytic therapy of Urokinase Tech-Pool (UKTP) in acute myocardial infarction (AMI).

METHODS

The data were collected from the 148 participating hospitals from November, 1994 to April, 1996. A total of 1,406 patients with AMI were analyzed to evaluate the clinical efficacy, side effects and mortality of UKTP. The patency of the infarct-related artery (IRA) was evaluated in 124 patients by coronary artery angiography (CAG) 90 minutes after the onset of UKTP infusion.

RESULTS

The reperfusion rate in IRA was 73.5% by clinical standards. The patency rate was 72.6% by CAG. The total mortality during the first 5 weeks was 7.8% (109/1,406). The rate of minor bleeding was 10.2% (143/1,406), of major bleeding 0.43% (6/1,406) and of intracranial hemorrhage 0.50% (7/1,406). In elderly patients (> 75 years old), UKTP was as effective and safe as in younger patients (< 65 years old). Late thrombolytic therapy with UKTP (> 6 hours after the onset of symptom) was still effective. The appropriate dosage of UKTP might be 150 million units of infusion within 30 minutes.

CONCLUSION

UKTP is an effective, reliable and safe agent in the thrombolytic therapy of AMI.