Improved prognosis after coronary thrombolysis with urokinase in acute myocardial infarction.

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The effectiveness of coronary thrombolysis with urokinase (UK) on short- and long-term outcome after acute myocardial infarction was studied by comparison of 120 patients treated with UK and 124 with conventional therapy followed up for a period of 20 months. UK was administered to patients within 6hours of the onset of chest pain, by the intracoronary route (20, 000U/min, at a mean dose of 698, 000U) in 46 patients, intravenously (960, 000 to 1, 920, 000U in 15 or 30min, at a mean dose of 1, 293, 000U) in 56 patients and by the combined route (at a mean dose of 2, 333, 000U) in 18 patients. Complete occlusion or 99% stenosis with severe delay of the contrast medium was found in 72.5% and recanalization by UK was achieved in 68.0%. Cumulative mortality rate was significantly reduced in the UK group (9.2% vs. 29.0%). Cardiac death from recurrent MI was also significantly reduced (2.5% vs. 10.5%). The reduction in mortality rate was demonstrated even in older patients as well as in those cases graded as severe according to the Killip and Forrester classifications. Thus, it is concluded that coronary thrombolysis with UK therapy improves the prognosis of acute myocardial infarction.
International Heart Journal刊行会の論文