Collaborative Angiographic Patency Trial Of Recombinant Staphylokinase (CAPTORS II)

Area of Science:

• Cardiology
• Pharmacology
• Biochemistry

Background:

• Developing effective and cost-efficient fibrinolytic agents for acute myocardial infarction (AMI) is crucial.
• Pegylated staphylokinase (PEG-Sak) has shown promise in pilot studies for achieving rapid Thrombolysis In Myocardial Infarction (TIMI) 3 flow.

Purpose of the Study:

• To determine an optimal dose of PEG-Sak for AMI treatment.
• To compare the efficacy and safety of PEG-Sak against recombinant tissue plasminogen activator (rt-PA).

Main Methods:

• A dose-ranging study of PEG-Sak in 378 patients with acute ST-elevation myocardial infarction (STEMI).
• Comparison of TIMI 3 flow rates between various PEG-Sak doses and accelerated rt-PA in 122 patients.
• Safety assessment, including intracranial hemorrhage events, was monitored.

Main Results:

• Intracranial hemorrhage occurred in 3 patients at higher PEG-Sak doses (0.15 mg/kg and 0.05 mg/kg), leading to dose adjustments.
• At doses of 0.01875 to 0.0375 mg/kg, PEG-Sak achieved TIMI 3 flow rates of 33%.
• The highest dose of PEG-Sak (0.05 mg/kg) demonstrated a TIMI 3 flow rate of 41%, similar to rt-PA (41%).

Conclusions:

• PEG-Sak demonstrates comparable efficacy to rt-PA in achieving TIMI 3 flow in STEMI patients.
• The ease of administration of PEG-Sak supports its further investigation.
• Optimizing PEG-Sak dosage is key to balancing efficacy and safety in fibrinolytic therapy for AMI.