[Initial experiences with pro-urokinase in acute myocardial infarct]

Pro-urokinase is a fibrin-specific, single-chain, high molecular form of urokinase that induces thrombolysis without fibrinogenolysis in experimental animals. Consequently, the potential advantage of pro-urokinase is that its activation can be limited to the site of a clot. Its efficiency was assessed in ten patients with acute transmural myocardial infarction. Reperfusion occurred in only two patients. In five out of seven patients with persistent complete coronary occlusion, clot lysis could be achieved by intracoronary streptokinase application within 30 min after completion of the pro-urokinase infusion. Fibrinogen and alpha 2-antiplasmin changed only moderately during pro-urokinase infusion. These preliminary data may indicate a limited thrombolytic efficiency of pro-urokinase in patients with acute myocardial infarction.