Why the study?
Does double bolus urokinase improve 90-minute infarct-related artery patency and LV function in patients with acute myocardial infarction compared to standard infusion methods?
Does double bolus urokinase improve 90-minute infarct-related artery patency and LV function in patients with acute myocardial infarction compared to standard infusion methods?
Double bolus IV injection of urokinase was more effective than conventional infusion methods for achieving optimal 90-minute reperfusion in AMI patients without increasing bleeding complications.
Double bolus urokinase was associated with higher IRA patency; hypothesis-generating and requires randomized confirmation before practice change.
Background and Purpose：Although thrombolytic strategies with streptokinase(STK and tissue-type plasminogen activator(t-PA in the treatment of acute myocardial infarction(AMI have been studied in large-scale clinical trials in the western countries, such large-scale studies with urokinase(UK are scanty. Even though UK is most commonly used thrombolytic agent for the treatment of AMI in Korea, there is no consensus on the dosage and the way of administration of UK in patients with AMI. Accordingly, a prospective clinical study was performed to evaluate the effects of thrombolytic strategies of intravenous double bolus method and standard double-infusion method with different dosage of UK in the treatment of AMI. Subjects and Methods：Ninety three patients with AMI(male 75, female 18, age 57.5±10.8 years were studied. The patients were divided into 3 groups according to dosage of UK and method of administration. Group Ⅰ：19 patients who received 1.5 million U of UK Ⅳ bolus, followed by 1.5 million U Ⅳ infusion for an hour(High Dose Group. Group Ⅱ：34 patients received 20,000U/kg body weight of UK Ⅳ bolus, followed by 20,000U/kg Ⅳ infusion for an hour(Double Dose Group. Group Ⅲ：40 patients received 1.5 million U of UK Ⅳ bolus and followed by 20,000U/kg Ⅳ bolus in 30 minutes with total dose of no more than 3 million U(Double Bolus Group. Coronary angiography(CAG and left ventriculography(LVG were performed 90 minutes after the administration of UK and post-AMI 7– 10 days to investigate the patency of infarct-related artery(IRA and LV function. Patency of IRA was graded according to the extent of flow of IRA. TIMI grade 0-1 was regarded as occluded, and grade 2-3 flow as patent. LV ejection fraction(EF
No takes yet. Share an insight, caveat, or question.
Rha et al. (1997) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: