Preview

Rational Pharmacotherapy in Cardiology

Advanced search

THE RESULTS OF USE OF NEW NATIVE THROMBOLYTIC IN CLINICAL PRACTICE

https://doi.org/10.20996/1819-6446-2016-12-2-160-165

Abstract

Aim. To assess the efficacy of thrombolytic Fortelyzin in ST elevation myocardial infarction (STEMI) in real clinical practice.
Material and methods. Fortelyzin was administered intravenously to 38 patients with STEMI with follow-up assessment of reperfusion success by ECG and angiographic criteria. Bleedings, anaphylaxis and total mortality were considered.
Results. The ST-segment resolution up to 70% in 180 min was reached in 66% of patients and angiographic effect TIMI 2-3 – in 60% of patients. The major bleeding rate was 2.6%, allergic reactions – 0%, total mortality – 10.5%. Unsuccessful reperfusion was observed more frequently in patients with ECG ischemia of grade 3 and with angiographic visualization of the collateral blood flow.
Conclusion. The general efficacy of Fortelyzin in real clinical practice was 73%. ECG ischemia of grade 3 and the presence of angiographic collateral blood flow predict unsuccessful reperfusion of the infarct-related artery.

About the Authors

E. S. Mazur
Tver State Medical University, Tver
Russian Federation


R. M. Rabinovich
Regional Clinic Hospital, Tver
Russian Federation


V. V. Mazur
Tver State Medical University, Tver
Russian Federation


N. S. Kuznetsova
Tver State Medical University, Tver
Russian Federation


E. A. Kudryashova
Regional Clinic Hospital, Tver
Russian Federation


S. V. Veselov
Tver State Medical University, Tver
Russian Federation


References

1. Libby P., Braunwald E. Braunwald's heart disease. Philadelphia: Saunders/Elsevier; 2008.

2. Inoue T., Nishiki R., Kageyama M., et al. Long-term benefits of monteplase before coronary angioplasty in acute myocardial infarction. The American Journal of Cardiology 2005;95(4):506-8.

3. Vachharajani N., Raymond R., Shyu W., et al. The effects of age and gender on the pharmacokinetics and pharmacodynamics in healthy subjects of the plasminogen activator, lanoteplase. British Journal of Clinical Pharmacology 2011;72(5):775-86.

4. Pannell R., Li S., Gurewich V. Highly Effective Fibrinolysis by a Sequential Synergistic Combination of MiniDose tPA plus Low-Dose Mutant proUK. PLOS ONE 2015;10(3):e0122018.

5. Markin S.S., Semenov A.M., Arzamascev E.V. et al. Fortelyzin in patients with acute myocardial infarction. Meditsinskiy Akademicheskiy Zhurnal 2012;12(1):80-86 (Маркин С.С.; Семенов А.М.; Арзамасцев Е.В. и др. Доклиническое и клиническое исследование фибринселективного тромболитического препарата Фортелизин. Медицинский Академический Журнал 2012;12(1):80-86).

6. Steg P., James S., Atar D., et al. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC). European Heart Journal 2012;33(20):2569-619.

7. Gibson C., Cannon C., Daley W., et al. TIMI Frame Count: A Quantitative Method of Assessing Coronary Artery Flow. Circulation 1996;93(5):879-88.

8. Pérez de Prado A, Fernández-Vázquez F, Cuellas-Ramón J, Gibson C. Coronary Angiography: Beyond Coronary Anatomy. Revista Española de Cardiología (EnglishEdition) 2006;59(6):596-608.

9. Rentrop KP, Cohen M, Blanke H, Phillips R. Changes in collateral channel filling immediately after controlled coronary artery occlusion by an angioplasty balloon in human subjects. Journal of the American College of Cardiology 1985;5(3):587-92.

10. An International Randomized Trial Comparing Four Thrombolytic Strategies for Acute Myocardial Infarction. New England Journal of Medicine 1993;329(10):673-82.

11. Lundergan C., Reiner J., McCarthy W., et al. Clinical predictors of early infarct-related artery patency following thrombolytic therapy: importance of body weight, smoking history, infarct-related artery and choice of thrombolytic regimen: the GUSTO-I experience. Journal of the American College of Cardiology 1998;32(3):641-7.

12. Billgren T., Maynard C., Christian T., et al. Grade 3 ischemia on the admission electrocardiogram predicts rapid progression of necrosis over time and less myocardial salvage by primary angioplasty. Journal of Electrocardiology 2005;38(3):187-94.

13. Kurt M., Karakas M., Buyukkaya E., et al. Relation of Angiographic Thrombus Burden With Electrocardiographic Grade III Ischemia in Patients With ST-Segment Elevation Myocardial Infarction. Clinicaland Applied Thrombosis/Hemostasis 2013;20(1):31-6.

14. Gibson C., de Lemos J., Murphy S., et al. Combination Therapy With Abciximab Reduces Angiographically Evident Thrombus in Acute Myocardial Infarction : A TIMI 14 Substudy. Circulation 2001;103(21): 2550-4.

15. Yip H., Chen M., Chang H., et al. Angiographic Morphologic Features of Infarct-Related Arteries and Timely Reperfusion in Acute Myocardial Infarction. Chest 2002;122(4):1322-32.

16. Yaylak B., Altintas B., Ede H., et al. Impact of Coronary Collateral Circulation on In-Hospital Death in Patients with Inferior ST Elevation Myocardial Infarction. Cardiol Res Pract 2015;2015:242686.

17. Meier P., Hemingway H., Lansky A., et al. The impact of the coronary collateral circulation on mortality: a meta-analysis. European Heart Journal 2011;33(5):614-21.


Review

For citations:


Mazur E.S., Rabinovich R.M., Mazur V.V., Kuznetsova N.S., Kudryashova E.A., Veselov S.V. THE RESULTS OF USE OF NEW NATIVE THROMBOLYTIC IN CLINICAL PRACTICE. Rational Pharmacotherapy in Cardiology. 2016;12(2):160-165. (In Russ.) https://doi.org/10.20996/1819-6446-2016-12-2-160-165

Views: 1516


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)