Angiographically assessed coronary arterial patency and reocclusion in patients with acute myocardial infarction treated with anistreplase: Results of the anistreplase reocclusion multicenter study (ARMS)

• Published in: The American journal of cardiology Vol. 68; no. 4; pp. 296 - 300
• Main Authors: Wely, Lucy Relik-van, Visser, Rombout F., van der Pol, Joop M.J., Bartholomeus, Ingrid, Couvée, Jaap E., Drost, Henk, Vet, AndréJ.T.M., Klomps, Huib C., van Ekelen, Wim A.A.J., van den Berg, Fred, Krauss, X.Hanno
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.08.1991; Elsevier
• Subjects: Adult; Aged; Anistreplase - adverse effects; Anistreplase - therapeutic use; Biological and medical sciences; Blood. Blood coagulation. Reticuloendothelial system; Coronary Angiography; Creatine Kinase - blood; Electrocardiography; Female; Follow-Up Studies; Humans; Isoenzymes; Male; Medical sciences; Middle Aged; Myocardial Infarction - diagnostic imaging; Myocardial Infarction - drug therapy; Myocardial Infarction - enzymology; Pharmacology. Drug treatments; Recurrence; Thrombolytic Therapy; Time Factors; Vascular Patency - drug effects; Human; Chemotherapy; Treatment; Intravenous administration; Angiography; Infarct; Radiodiagnosis; Coronary artery; Myocardium; Cardiovascular disease; Coronary heart disease; Fibrinolytic
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/0002-9149(91)90822-3

In this open multicenter study, 156 patients with acute myocardial infarction received 30 U of anistreplase intravenously over 5 minutes within 4 hours of the onset of chest pain. The patency of the infarct-related vessel was determined by coronary angiography 90 minutes after anistreplase treatment, and also 24 hours after treatment, in patients with a patent infarct-related vessel at 90 minutes, to assess the reocclusion rate. The investigators categorized the infarct-related vessel as patent or occluded, and 2 independent cardiologists graded the infarct-related vessel according to the Thrombolysis in Myocardial Infarction (TIMI) perfusion criteria. At the 90-minute assessment, 106 of 145 evaluable patients (73%) had patent infarct-related vessels, and 39 of 145 (27%) had occluded infarct-related vessels. Of the 139 independently assessed patients, 98 (71%) had TIMI grades 2 or 3 and 41 (29%) had TIMI grades 0 or 1. At the 24-hour assessment, 98 of 102 patients (96%) had a patent infarct-related vessel, and reocclusion had occurred in 4 of 102 patients (4%). Of the 94 independently assessed patients 90 (96%) had TIMI grades 2 or 3, and 4 (4%) had TIMI grades 0 or 1. The reliability of noninvasive parameters as indicators of achieved patency of the infarct-related vessel was estimated by means of correlation with patency assessed by coronary angiography. A significant correlation of 0.62 was found. The patency rate of 71 to 73% after use of anistreplase in patients with acute myocardial infarction corresponds with findings in earlier studies. The low reocclusion rate of 4% after use of anistreplase probably reflects the prolonged action of anistreplase.