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급성심근경색증 환자의 혈전용해치료에서 Double Bolus Urokinase와 Front-Loaded Alteplasem요법의 전향적 무작위 비교연구

Other Titles
 A Randomized Comparison of Double Bolus Urokinase versus Front-Loaded Alteplase Regimen for Acute Myocardial Infarction 
 TIMIKO (Thrombolysis in Myocardial Infarction in Korea) 연구회 
 Korean Circulation Journal (순환기), Vol.28(10) : 1664-1669, 1998 
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Background : This study was performed to compare double bolus urokinase (UK) regimen with front-loaded alteplase regimen for acute myocardial infarction (AMI). Methods : In 26 hospitals, 618 patients with AMI within 6 hours after onset of pain were randomized to receive double bolus UK (UK 1.5 million units intravenous bolus injection, followed by UK 20,000 units /kg intravenous bolus injection 30 minutes after the first dose (up to 1.5 million units) or front-loaded alteplase. Coronary angiography was performed 90 min (N= 200) and/or 7 days (N=303) after thrombolytic therapy. The primary end point was a composite outcome of death, nonfatal reinfarction and nonfatal stroke within 30 days. There were no differences in baseline clinical characteristics. Results : TIMI grade 3 antegrade flow of infarct-related artery at 90 minutes was achieved after treatment with double bolus UK (69.9 %, 79/113) or front-loaded alteplase (67.8 %, 59/87) (p=NS). Angiographic patency at 7 days after thrombolytic therapy was also similar in both groups (81.7 % vs 77.8%). There was no significant difference in 30-day mortality between both groups (4.6 %, 16/350 vs 4.4 %, 12/268 p=NS). The rates of major hemorrhagic strokes was 0.3 % (1/350) in UK group and 1.1 % (3/268) in alteplase group (p=NS). No difference was observed in the rate ofreinfarction between both groups (3.1 %,11/350 vs 3. 4 %, 9/268 , p=NS). A composite outcome was also similar in both groups (8.0 % vs 8.9 %, p=NS ). Conclusions : Double bolus urokinase is an easy, safe and effective thrombolytic regimen with comparable results to standard front-loaded alteplase in the treatment of acute myocardial infarction.
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Cho, Seung Yun(조승연)
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