Preliminary safety and tolerance data obtained in the comparative study of anisoylated plasminogen streptokinase...

The safety/tolerance of anisoylated plasminogen streptokinase activator complex (APSAC) versus heparin therapy in acute myocardial infarction has been studied in the first 65 patients treated in a multicentre study. A transient marked hypotensive effect was observed in 2 patients on APSAC given over 2 minutes. Primary ventricular arrhythmias during the first 4 hours after treatment occurred in 16 APSAC-treated patients and in 7 patients who received heparin; in 88% of the cases on APSAC these arrhythmias were reported by the investigators as being associated with reperfusion. Vomiting, shivering and fever were reported transiently in 2 APSAC-treated patients. Bleeding occurred in 7 patients in the APSAC group; none of these required transfusions, but the heparin dosage was adjusted in 1 patient. A reduction of blood haemoglobin was observed in 4 APSAC- and 2 heparin-treated patients; these were possibly drug-related. Three patients on APSAC died, while in the heparin group 4 deaths were reported.