PMID- 14739626
OWN - NLM
STAT- MEDLINE
DCOM- 20041008
LR  - 20181113
IS  - 0929-5305 (Print)
IS  - 0929-5305 (Linking)
VI  - 15
IP  - 3
DP  - 2003 Jun
TI  - Efficacy and safety of a new streptokinase regimen with enoxaparin in acute 
      myocardial infarction.
PG  - 171-9
AB  - OBJECTIVE: To compare a new streptokinase regimen combined with either enoxaparin 
      or unfractionated heparin (UFH) and the traditional streptokinase regimen 
      combined with UFH in patients with acute myocardial infarction (AMI). METHODS: 
      412 patients (<75 years), hospitalized within 6 hours of the onset of chest pain, 
      were allocated thrombolytic therapy by the treating physician: streptokinase 0.75 
      MU/10 minutes, repeated if no coronary reperfusion after one dose, plus 
      enoxaparin 40 mg intravenously followed by 1 mg/kg bodyweight subcutaneously at 
      12-hour intervals for 5-7 days (n = 102); the same streptokinase regimen plus UFH 
      1000 IU/60 minutes intravenously for 48-72 hours ( n = 106); or streptokinase 1.5 
      MU/60 minutes plus the same UFH regimen (n = 204). All patients received 250-325 
      mg aspirin/day. Coronary reperfusion rates, 30-day mortality and hemorrhagic 
      complications were recorded. RESULTS: Coronary reperfusion rates with 0.75 
      streptokinase + enoxaparin (78.4%) and 0.75 streptokinase + UFH (74.5%) were 
      significantly higher than those with 1.5 streptokinase + UFH (62.2%), but there 
      was no significant difference between the groups receiving the new regimen. 
      Overall 30-day mortality (6.3%) was significantly lower than with 1.5 
      streptokinase + UFH (12.7%) ( p = 0.037). The incidence of major and minor 
      hemorrhagic events was similar in all groups. CONCLUSIONS: The accelerated 
      streptokinase regimen was well tolerated and resulted in a significantly higher 
      coronary reperfusion rate and significantly lower mortality compared with the 
      traditional regimen. The 0.75 streptokinase + enoxaparin combination was at least 
      as efficacious as the 0.75 streptokinase + UFH combination and is preferred 
      because of its ease of administration and predictable anticoagulant effect.
FAU - Tatu-Chitoiu, Gabriel
AU  - Tatu-Chitoiu G
AD  - Clinic of Cardiology, Emergency Hospital/Outpatient Clinic, Calea Floreasca nr. 8 
      sector 1, 79406 Bucharest, Romania. gabitatu@hotmail.com
FAU - Teodorescu, Cristina
AU  - Teodorescu C
FAU - Dan, Monica
AU  - Dan M
FAU - Capraru, Petre
AU  - Capraru P
FAU - Guran, Manuela
AU  - Guran M
FAU - Istratescu, Oana
AU  - Istratescu O
FAU - Tatu-Chitoiu, Alexandrina
AU  - Tatu-Chitoiu A
FAU - Bumbu, Aurelia
AU  - Bumbu A
FAU - Dorobantu, Maria
AU  - Dorobantu M
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Netherlands
TA  - J Thromb Thrombolysis
JT  - Journal of thrombosis and thrombolysis
JID - 9502018
RN  - 0 (Enoxaparin)
RN  - 9005-49-6 (Heparin)
RN  - EC 3.4.- (Streptokinase)
SB  - IM
MH  - Aged
MH  - Drug Therapy, Combination
MH  - Enoxaparin/*administration & dosage
MH  - Female
MH  - Heparin/administration & dosage
MH  - Humans
MH  - Hypotension/chemically induced
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*drug therapy/mortality
MH  - Myocardial Reperfusion/methods
MH  - Streptokinase/*administration & dosage/adverse effects
MH  - Survival Rate
EDAT- 2004/01/24 05:00
MHDA- 2004/10/09 09:00
CRDT- 2004/01/24 05:00
PHST- 2004/01/24 05:00 [pubmed]
PHST- 2004/10/09 09:00 [medline]
PHST- 2004/01/24 05:00 [entrez]
AID - 5254966 [pii]
AID - 10.1023/B:THRO.0000011372.26594.01 [doi]
PST - ppublish
SO  - J Thromb Thrombolysis. 2003 Jun;15(3):171-9. doi: 
      10.1023/B:THRO.0000011372.26594.01.