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, Volume 33, Supplement 3, pp 231–234 | Cite as

Prehospital Administration of Anisoylated Plasminogen Streptokinase Activator Complex in Acute Myocardial Infarction

  • A. D. Castaigne
  • A. M. Duval
  • J. L. Dubois-Rande
  • C. Herve
  • F. Jan
  • Y. Louvard
Section 3: Efficacy of Anisoylated Plasminogen Streptokinase Activator Complex: Evidence of Myocardial Function and Mortality Benefit Poster Presentations

Summary

25 patients have been included in a randomised trial aimed to compare prehospital and hospital administration of anisoylated plasminogen streptokinase activator complex (APSAC). Patients were first seen, at home, by a noncardiologist doctor working in a mobile-care unit and were then evaluated for entry into the study. If they had evidence of myocardial infarction lasting for less than 3 hours and if there was no contraindication to thrombolytic therapy they were randomly allocated to APSAC SOU or placebo. They were next referred to an intensive coronary unit (ICU). On arrival in the ICU patients were reevaluated and received APSAC if they had previously received placebo. For 24 patients, diagnosis of myocardial infarction was confirmed. One patient died at home after having received placebo. There was 1 hospital death. At-home injection was made within a median of 124 minutes after the beginning of pain, whereas hospital administration was made after a median of 180 minutes. On a clinical basis reperfusion occurred in 16 out of 21 evaluable patients. Four patients had coronary artery bypass graft surgery and 9 had angioplasty. We conclude that prehospital administration of APSAC is feasible, well-tolerated and is a good way to shorten the delay of thrombolytic treatment in myocardial infarction.

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References

  1. Gruppo Italiano per lo Studio Delia Streptochinasi nell’Infarto Miocardico (GISSI), Effectiveness of intravenous thrombolytic treatment in acute myocardial infarction. Lancet 1: 397–402, 1986Google Scholar
  2. ISAM Study Group. A prospective trial of intravenous streptokinase in acute myocardial infarction (ISAM). New England Journal of Medicine 314: 1465–1471, 1986CrossRefGoogle Scholar
  3. Koren G, Weiss AT, Hasin Y, et al. Prevention of myocardial damage in acute myocardial ischemia by early treatment with intravenous streptokinase. New England Journal of Medicine 313: 1384–1389, 1985PubMedCrossRefGoogle Scholar

Copyright information

© ADIS Press Limited 1987

Authors and Affiliations

  • A. D. Castaigne
    • 1
  • A. M. Duval
    • 1
  • J. L. Dubois-Rande
    • 1
  • C. Herve
    • 2
  • F. Jan
    • 3
  • Y. Louvard
    • 4
  1. 1.Department of Cardiology (Pr P. Vernant)Hôpital Henri MondorCreteilFrance
  2. 2.SAMU 94Hôpital Henri MondorCreteilFrance
  3. 3.Department of Internal MedicineHôpital Henri MondorCreteilFrance
  4. 4.Department of CardiologyHôpital Emile RouxBrevannesFrance

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