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Randomised multicentre trial of APSAC versus heparin. Interim results
70
THROMBOSIS RESEARCH
Suppl . VII,
I??NDOMISEJJ MULTICRNTRR TRIAL OF APSAC VERSUS HEPARIN. INTERIM RESULTS. Th. Meinertz, on behalf of the German European Multicentre Study (EMS) Group Klinikum der Albert-Ludwigs-Universitat, Med. Universit'rlts-Klinik, Freiburg
Few clinical studies have been performed that compare the influence of plasminogen activators and conventional thrombolytic agents on mortality and left ventricular function in patients with acute myocardial infarction. A large, multicentre, randomised study was therefore initiated in Germany to canpare the influence of anisoylated plasminogen streptokinase activator complex (APSAC) and heparin on these parameters. The study began at the end of 1985 with the intention to include 300 patients. This trial population was estimated on the assumption that hospital mortality would be about 12% in the heparin group and 4 to 5% in the APSAC group; a percentage reduction in mortality similar to that reported in the Western Washington Trial of intracoronary streptokinase. Patients with a first acute myocardial infarction and a duration of symptoms of less than 4 hours were stratified according to infarct site and randomised to treatment with APSAC 30 U intravenously or heparin 5000 U as a bolus injection. 18 hospitals, mostly community hospitals have participated in the study. The results of about 300 patients will be presented i.e. in-hospital mortality, reperfusion and ventricular function data and adverse events. The primary centre participating in this study, Freiburg, performed in their sub-group of the trial population some additional investigations to assess reperfusion and infarct size. The technique used was the simultaneous intravenous injection of thallium and technitium pyrophosphate. An overlap between the location of the two markers was indicative of successful reperfusion, and from this a semi-quantitative measure of infarct size could be made. It can be concluded that early APSAC therapy in acute myocardial infarction is superior to heparin with respect to reperfusion of occluded or partially occluded coronary arteries, preservation of left ventricular function in patients with anterior infarction, and with respect to reduction of in-hospital mortality.
1987
THROMBOSIS RESEARCH
Suppl . VII,
I??NDOMISEJJ MULTICRNTRR TRIAL OF APSAC VERSUS HEPARIN. INTERIM RESULTS. Th. Meinertz, on behalf of the German European Multicentre Study (EMS) Group Klinikum der Albert-Ludwigs-Universitat, Med. Universit'rlts-Klinik, Freiburg
Few clinical studies have been performed that compare the influence of plasminogen activators and conventional thrombolytic agents on mortality and left ventricular function in patients with acute myocardial infarction. A large, multicentre, randomised study was therefore initiated in Germany to canpare the influence of anisoylated plasminogen streptokinase activator complex (APSAC) and heparin on these parameters. The study began at the end of 1985 with the intention to include 300 patients. This trial population was estimated on the assumption that hospital mortality would be about 12% in the heparin group and 4 to 5% in the APSAC group; a percentage reduction in mortality similar to that reported in the Western Washington Trial of intracoronary streptokinase. Patients with a first acute myocardial infarction and a duration of symptoms of less than 4 hours were stratified according to infarct site and randomised to treatment with APSAC 30 U intravenously or heparin 5000 U as a bolus injection. 18 hospitals, mostly community hospitals have participated in the study. The results of about 300 patients will be presented i.e. in-hospital mortality, reperfusion and ventricular function data and adverse events. The primary centre participating in this study, Freiburg, performed in their sub-group of the trial population some additional investigations to assess reperfusion and infarct size. The technique used was the simultaneous intravenous injection of thallium and technitium pyrophosphate. An overlap between the location of the two markers was indicative of successful reperfusion, and from this a semi-quantitative measure of infarct size could be made. It can be concluded that early APSAC therapy in acute myocardial infarction is superior to heparin with respect to reperfusion of occluded or partially occluded coronary arteries, preservation of left ventricular function in patients with anterior infarction, and with respect to reduction of in-hospital mortality.
1987