ESPRIT: A European study of the prevention of reocclusion after initial thrombolysis with duteplase in acute myocardial infarction

A. D. Malcolm, M. Keltai, M. J. Walsh, G. Hennersdorf, D. Dymond, J. Fabian, J. Sochman, M. Bertrand, C. Masquet, B. Letac, M. Bory, J. Eha, C. De Vita, P. Ravazzi, E. Gatto, F. Abbadessa, J. Perrins, K. Daly, G. Von der Lippe

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background. The goal of thrombolytic treatment in acute myocardial infarction is reperfusion of the infarct-related coronary artery. Duteplase is a double-chain recombinant tissue-type plasminogen activator. Its efficacy and safety were evaluated in patients with acute myocardial infarction treated within 4 h of onset of chest pain in this multicentre, open, non-controlled trial. Methods and results. A total of 273 patients were enrolled and treated with duteplase 0.6 MU.kg-1 over 4 h, with concomitant oral aspirin and intravenous heparin. Coronary arteriography was performed at 60 min, 90 min and approximately 24 h after the start of duteplase infusion to assess the perfusion grade (TIMI scoring) of the infarct-related coronary artery. Safety was assessed by monitoring patients closely for bleeding and for all other adverse experiences during the 72-h study. period. Reinfarction during the study period was also recorded, and deaths at any time during the period in hospital were documented. TIMI grade 2 or 3 patency of the infarct-related coronary artery at 90 min was achieved in 70% of the patients and 7% of these 'patent' infarct-related coronary arteries had reoccluded by 20 to 36 h. Clinical reinfarction during the 72-h study period was observed in 7%. Total in-hospital mortality was 8%. Serious or life-threatening bleeding occurred in 4% of the patients. There was one haemorrhagic stroke, and this was fatal. Conclusions. Weight-adjusted duteplase infusion, together with oral aspirin and intravenous heparin, in acute myocardial infarction resulted in patency of the infarct-related coronary artery and a safety profile comparable to those reported for the other form of tissue-type plasminogen activator, alteplase. However, there remains a problem with reocclusion and reinfarction after initially successful thrombolysis.

Original languageEnglish
Pages (from-to)1522-1531
Number of pages10
JournalEuropean Heart Journal
Volume17
Issue number10
Publication statusPublished - 1996

Fingerprint

Coronary Vessels
Myocardial Infarction
Tissue Plasminogen Activator
Safety
Aspirin
Heparin
Hemorrhage
Physiologic Monitoring
Hospital Mortality
Chest Pain
Reperfusion
Angiography
Perfusion
Stroke
duteplase
Weights and Measures
Therapeutics

Keywords

  • Acute myocardial infarction
  • Ateriographic patency
  • Duteplase
  • Safety
  • t-PA
  • Thrombolysis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Malcolm, A. D., Keltai, M., Walsh, M. J., Hennersdorf, G., Dymond, D., Fabian, J., ... Von der Lippe, G. (1996). ESPRIT: A European study of the prevention of reocclusion after initial thrombolysis with duteplase in acute myocardial infarction. European Heart Journal, 17(10), 1522-1531.

ESPRIT : A European study of the prevention of reocclusion after initial thrombolysis with duteplase in acute myocardial infarction. / Malcolm, A. D.; Keltai, M.; Walsh, M. J.; Hennersdorf, G.; Dymond, D.; Fabian, J.; Sochman, J.; Bertrand, M.; Masquet, C.; Letac, B.; Bory, M.; Eha, J.; De Vita, C.; Ravazzi, P.; Gatto, E.; Abbadessa, F.; Perrins, J.; Daly, K.; Von der Lippe, G.

In: European Heart Journal, Vol. 17, No. 10, 1996, p. 1522-1531.

Research output: Contribution to journalArticle

Malcolm, AD, Keltai, M, Walsh, MJ, Hennersdorf, G, Dymond, D, Fabian, J, Sochman, J, Bertrand, M, Masquet, C, Letac, B, Bory, M, Eha, J, De Vita, C, Ravazzi, P, Gatto, E, Abbadessa, F, Perrins, J, Daly, K & Von der Lippe, G 1996, 'ESPRIT: A European study of the prevention of reocclusion after initial thrombolysis with duteplase in acute myocardial infarction', European Heart Journal, vol. 17, no. 10, pp. 1522-1531.
Malcolm, A. D. ; Keltai, M. ; Walsh, M. J. ; Hennersdorf, G. ; Dymond, D. ; Fabian, J. ; Sochman, J. ; Bertrand, M. ; Masquet, C. ; Letac, B. ; Bory, M. ; Eha, J. ; De Vita, C. ; Ravazzi, P. ; Gatto, E. ; Abbadessa, F. ; Perrins, J. ; Daly, K. ; Von der Lippe, G. / ESPRIT : A European study of the prevention of reocclusion after initial thrombolysis with duteplase in acute myocardial infarction. In: European Heart Journal. 1996 ; Vol. 17, No. 10. pp. 1522-1531.
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abstract = "Background. The goal of thrombolytic treatment in acute myocardial infarction is reperfusion of the infarct-related coronary artery. Duteplase is a double-chain recombinant tissue-type plasminogen activator. Its efficacy and safety were evaluated in patients with acute myocardial infarction treated within 4 h of onset of chest pain in this multicentre, open, non-controlled trial. Methods and results. A total of 273 patients were enrolled and treated with duteplase 0.6 MU.kg-1 over 4 h, with concomitant oral aspirin and intravenous heparin. Coronary arteriography was performed at 60 min, 90 min and approximately 24 h after the start of duteplase infusion to assess the perfusion grade (TIMI scoring) of the infarct-related coronary artery. Safety was assessed by monitoring patients closely for bleeding and for all other adverse experiences during the 72-h study. period. Reinfarction during the study period was also recorded, and deaths at any time during the period in hospital were documented. TIMI grade 2 or 3 patency of the infarct-related coronary artery at 90 min was achieved in 70{\%} of the patients and 7{\%} of these 'patent' infarct-related coronary arteries had reoccluded by 20 to 36 h. Clinical reinfarction during the 72-h study period was observed in 7{\%}. Total in-hospital mortality was 8{\%}. Serious or life-threatening bleeding occurred in 4{\%} of the patients. There was one haemorrhagic stroke, and this was fatal. Conclusions. Weight-adjusted duteplase infusion, together with oral aspirin and intravenous heparin, in acute myocardial infarction resulted in patency of the infarct-related coronary artery and a safety profile comparable to those reported for the other form of tissue-type plasminogen activator, alteplase. However, there remains a problem with reocclusion and reinfarction after initially successful thrombolysis.",
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T2 - A European study of the prevention of reocclusion after initial thrombolysis with duteplase in acute myocardial infarction

AU - Malcolm, A. D.

AU - Keltai, M.

AU - Walsh, M. J.

AU - Hennersdorf, G.

AU - Dymond, D.

AU - Fabian, J.

AU - Sochman, J.

AU - Bertrand, M.

AU - Masquet, C.

AU - Letac, B.

AU - Bory, M.

AU - Eha, J.

AU - De Vita, C.

AU - Ravazzi, P.

AU - Gatto, E.

AU - Abbadessa, F.

AU - Perrins, J.

AU - Daly, K.

AU - Von der Lippe, G.

PY - 1996

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N2 - Background. The goal of thrombolytic treatment in acute myocardial infarction is reperfusion of the infarct-related coronary artery. Duteplase is a double-chain recombinant tissue-type plasminogen activator. Its efficacy and safety were evaluated in patients with acute myocardial infarction treated within 4 h of onset of chest pain in this multicentre, open, non-controlled trial. Methods and results. A total of 273 patients were enrolled and treated with duteplase 0.6 MU.kg-1 over 4 h, with concomitant oral aspirin and intravenous heparin. Coronary arteriography was performed at 60 min, 90 min and approximately 24 h after the start of duteplase infusion to assess the perfusion grade (TIMI scoring) of the infarct-related coronary artery. Safety was assessed by monitoring patients closely for bleeding and for all other adverse experiences during the 72-h study. period. Reinfarction during the study period was also recorded, and deaths at any time during the period in hospital were documented. TIMI grade 2 or 3 patency of the infarct-related coronary artery at 90 min was achieved in 70% of the patients and 7% of these 'patent' infarct-related coronary arteries had reoccluded by 20 to 36 h. Clinical reinfarction during the 72-h study period was observed in 7%. Total in-hospital mortality was 8%. Serious or life-threatening bleeding occurred in 4% of the patients. There was one haemorrhagic stroke, and this was fatal. Conclusions. Weight-adjusted duteplase infusion, together with oral aspirin and intravenous heparin, in acute myocardial infarction resulted in patency of the infarct-related coronary artery and a safety profile comparable to those reported for the other form of tissue-type plasminogen activator, alteplase. However, there remains a problem with reocclusion and reinfarction after initially successful thrombolysis.

AB - Background. The goal of thrombolytic treatment in acute myocardial infarction is reperfusion of the infarct-related coronary artery. Duteplase is a double-chain recombinant tissue-type plasminogen activator. Its efficacy and safety were evaluated in patients with acute myocardial infarction treated within 4 h of onset of chest pain in this multicentre, open, non-controlled trial. Methods and results. A total of 273 patients were enrolled and treated with duteplase 0.6 MU.kg-1 over 4 h, with concomitant oral aspirin and intravenous heparin. Coronary arteriography was performed at 60 min, 90 min and approximately 24 h after the start of duteplase infusion to assess the perfusion grade (TIMI scoring) of the infarct-related coronary artery. Safety was assessed by monitoring patients closely for bleeding and for all other adverse experiences during the 72-h study. period. Reinfarction during the study period was also recorded, and deaths at any time during the period in hospital were documented. TIMI grade 2 or 3 patency of the infarct-related coronary artery at 90 min was achieved in 70% of the patients and 7% of these 'patent' infarct-related coronary arteries had reoccluded by 20 to 36 h. Clinical reinfarction during the 72-h study period was observed in 7%. Total in-hospital mortality was 8%. Serious or life-threatening bleeding occurred in 4% of the patients. There was one haemorrhagic stroke, and this was fatal. Conclusions. Weight-adjusted duteplase infusion, together with oral aspirin and intravenous heparin, in acute myocardial infarction resulted in patency of the infarct-related coronary artery and a safety profile comparable to those reported for the other form of tissue-type plasminogen activator, alteplase. However, there remains a problem with reocclusion and reinfarction after initially successful thrombolysis.

KW - Acute myocardial infarction

KW - Ateriographic patency

KW - Duteplase

KW - Safety

KW - t-PA

KW - Thrombolysis

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