[Coronary thrombolysis with defibrase]

Clinical use of defibrase (DF), a fibrinolytic agent from venom of Agkistrodon acutus, was investigated in patients with acute myocardial infarction (AMI). Patients with AMI were randomized to tow groups, one receiving conventional therapy and DF, the other a control group having conventional treatment only. The patients in the DF group received intravenous DF 0.05 u or 0.075 u/kg over 1 hour immediately after the attack and 0.025 u/kg over 4 hours on the 5 th and 10 th day. The control patients received conventional therapy only. Of the patients randomized, 21 had coronary angiography and left ventriculography. Recanalization was seen in 10 of the 10 patients treated with DF, while only in 3 of the 11 patients in the control group. LVEF in the DF group was higher than that in the control group (61% vs 50%). However the difference was not significant. In the DF group, two patients developed petechia and blood oozing at the site of intravenous injection and one patient developed gum bleeding; all patients had transient thrombocytopnia, which returned to normal within 5 days. There was no intracranial hemorrhage, gross hematuria or hematemesis. In conclusion, DF possess thrombolytic as well as anticoagulant effects with minor bleeding complication. Early infusion of DF yields high patency rate and shows a trend toward preservation of LV function.