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Controlled trial of urokinase in myocardial infarction. A European Collaborative Study
Insights
Urokinase treatment for acute myocardial infarction showed faster electrocardiographic changes but did not reduce mortality or improve cardiac function compared to glucose infusion over one year.
Area of Science:
- Cardiology
- Thrombolytic Therapy
Background:
- Acute myocardial infarction (AMI) is a leading cause of cardiac mortality.
- Early reperfusion strategies aim to limit infarct size and preserve cardiac function.
Purpose of the Study:
- To evaluate the efficacy of urokinase in patients with acute myocardial infarction.
- To compare urokinase treatment with glucose infusion regarding mortality and cardiac function.
Main Methods:
- 341 patients with AMI were randomized into two groups.
- One group received urokinase (172 patients), the other received glucose infusion (169 patients).
- All patients received anticoagulation therapy (heparin followed by oral anticoagulants).
Main Results:
- Faster regression of electrocardiographic alterations was observed in the urokinase group.
- No significant difference in 1-year mortality between urokinase (29 deaths) and control (24 deaths) groups.
- No difference in cardiac functional class was noted between the groups.
Conclusions:
- Urokinase does not improve survival or cardiac function in acute myocardial infarction patients despite faster ECG recovery.
- Glucose infusion serves as an effective control in evaluating thrombolytic therapy for AMI.
- Further research may explore alternative thrombolytic agents or combination therapies.
Abstract:
341 patients with acute myocardial infarction have been treated in intensive or coronary care units. They were randomised into two groups, 172 receiving urokinase and 169 receiving a glucose infusion. Thereafter they were anticoagulated first with heparin and then for a year with oral anticoagulants. Despite a significantly faster regression of electrocardiographic alterations in the urokinase group there was no difference in mortality during the 1-year follow-up (29 deaths in the urokinase and 24 in the control group) and no difference in cardiac functional class between both groups.