Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:3.4.21.73 (urokinase-type plasminogen activator)
 10,685 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The current revolution in the treatment of acute myocardial infarction by means of thrombolytic therapy has as its underlying strategy three aims: early restoration of the blood flow in order to salvage jeopardized but still viable tissues; limitation of acute consequences of ischemic heart disease, such as infarct size, ventricular fibrillation, and pericardial effusion; and preservation, as far as possible, of ventricular function. It is also hoped that these three achievements will result in reduced short- as well as long-term mortality rates. The techniques employed in this overall strategy are still under investigation, and several leading pharmacological compounds vie for supremacy: streptokinase (SK) and its anisoylated form (APSAC), recombinant technique tissue type plasminogen activator (rt-PA), and urokinase (UK) with or without prourokinase (PUK). Other pharmacological agents, such as angiotensin converting enzyme (ACE) inhibitors, beta-blockers, Ca2+ antagonists, and O2 radical scavengers, might find here their "finest hour" yet. In addition, the underlying anatomy may require early or, where needed, delayed PTCA, backed up by coronary artery bypass grafting. Thus, the tactics of the intervention may vary from case to case and indeed from center to center depending on experience and facilities, but the strategic conclusion is clearly the same: early reperfusion is a must if one wishes to save ischemic but still viable tissue.
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PMID:Acute consequences of ischemic myocardial damage. 248 24

Among 263 patients with acute myocardial infarction, 141 were treated with urokinase (UK group) and 122 received no urokinase (conventional group). Urokinase (UK) was administered intracoronarily in 55 cases; intravenously (mainly 1,920,000 units) in 64 cases; and intravenously and intracoronarily in 22 cases. The mortality rates were ascertained three months after admission and during the mean follow-up periods of 17.5 months for the UK group and 24.5 months for the conventional group. The three month mortality was significantly lower in the UK group (10.6%, 15 cases) than in the conventional group (23.8%, 29 cases) (p less than 0.01). The mortality during the entire follow-up period was also lower in the UK group (14.2%, 20 cases) than in the conventional group (26.2%, 32 cases) (p less than 0.05). Fatalities due to cardiac rupture, ventricular fibrillation, cardiac failure, cardiogenic shock and recurrent infarction were uniformly less in the UK group. It was concluded that coronary thrombolysis is an effective means of reducing mortality in acute myocardial infarction.
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PMID:[The effects of coronary thrombolysis on the short- and long-term mortality in acute myocardial infarction]. 281 55

In a canine copper coil-induced coronary thrombosis model, the differences in frequency of reperfusion arrhythmias (premature ventricular complexes: PVC) and mortality rate after thrombolysis by intravenous bolus injection of a novel modified tissue-type plasminogen activator (t-PA), E6010, and by continuous intravenous infusion of native t-PA or urokinase were evaluated. Rapid coronary occlusion and reperfusion were produced with a balloon catheter in another group of dogs, and the findings were compared with those in the thrombolysis groups. Reperfusion occurred gradually after the administration of E6010, but was significantly more rapid after administration of native t-PA and urokinase (P < 0.05). PVC were observed more frequently in native t-PA, urokinase and balloon occlusion-reperfusion groups than in the E6010 group. The mortality rate due to ventricular fibrillation was 0.0% in the E6010 group, 50.0% in the native t-PA and balloon occlusion-reperfusion groups, and 33.3% in the urokinase group. These results suggest that the more gradual reperfusion of the coronary artery at an earlier period after drug administration led to the lower frequency of reperfusion arrhythmias and low mortality rate in the E6010 group than in the native t-PA, urokinase and balloon occlusion-reperfusion groups.
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PMID:A novel modified tissue-type plasminogen activator (t-PA), E6010, gradually increases coronary blood flow after thrombolysis compared with native t-PA, urokinase and balloon catheter occlusion-reperfusion. 753 43

The degree of platelet activation and damage in 15 cases with acute myocardial infarction (AMI) receiving thrombolytic therapy and 15 cases with AMI receiving anticoagulant therapy were studied in vivo and in vitro by using specific monoclonal antibodies (SZ-51 & S12) against alpha-granule membrane protein 140 (GMP-140). Clinical indexes and myocardial enzyme changes in the two groups of patients were also observed. The results showed that the number of GMP-140 molecules on platelet surface and the concentration of GMP-140 in plasma were increased before treatment. The number of GMP-140 molecules on platelet surface began to decrease on the 1st day and returned to baseline on the 7th day after treatment. The concentration of GMP-140 in plasma reached a peak on the 1st day, began to fall on the 2nd day and returned to baseline on the 3rd day after treatment. There were no significant differences in the dynamic changes of number of GMP-140 molecules on platelet surface and the concentration of GMP-140 in plasma between groups of thrombolytic therapy and anticoagulant therapy. In vitro experiment showed that the thrombolytic medicine urokinase neither activated platelets nor inhibited platelet activation induced by thrombin. Significantly greater reperfusion rate and earlier appearance of CK and CK-MB peaks were found in the thrombolytic than in the anticoagulant group. LVEF determined by echocardiography, rate of return of ST segments to baseline and alleviation rate of chest pain were significantly greater and complications of AMI (ventricular fibrillation, left ventricular failure and angina) were less in the group receiving thrombolytic therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Dynamic observation of alpha-granule membrane protein 140 during the treatment of thrombolytic and anticoagulant therapy in patients with acute myocardial infarction]. 758 6

Thrombolytic therapy with intravenous domestic urokinase was carried out within 6 hours after onset in 40 cases of acute myocardial infarction from Feb. 1991 to Dec. 1992, the age of patients being 52.5 +/- 8.4 (37-74) years. The overall reperfusion rate was 65.0%; the reperfusion rate within 3 hours was 78.3% (18/23) and from 3 to 6 hours 47.1% (8/17) (P < 0.05). The incidence of reperfusion arrhythmia was 73.1%. Reinfarction occurred in 3 and acute allergy in 2 cases. 3 other cases developed ventricular fibrillation within 2 hours after onset. After prompt successful defibrillation, thrombolytic therapy was instituted and 2 cases had reperfusion. No marked bleeding and mortality were observed in all of our cases.
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PMID:[Intravenous thrombolysis with domestic urokinase in 40 cases of acute myocardial infarction]. 815 39

A 47-year-old man was referred by an emergency physician to the intensive care unit of a hospital under resuscitation conditions while having recurrent attacks of ventricular fibrillation. Coronary angiography, performed while resuscitation measures had to be maintained, revealed severe three-vessel disease with occlusion of the anterior interventricular branch at its origin. Electrical and haemodynamic instability persisted even after thrombolysis with urokinase and introduction of an intraaortic balloon pump. Percutaneous partial cardiopulmonary bypass (CPB) was, therefore, instituted and a cardiac output of 2.5 1 achieved together with a stable sinus rhythm and a systolic pressure of 60-80 mm Hg. After 9 h on CPB, drug administration could be levelled off and he was mobilised. He showed no neurological deficits and 4 months later he underwent an elective coronary bypass operation. This report demonstrates that even in conditions of resuscitation mechanical circulatory support can be undertaken rapidly and successfully, in the face of electrical instability, to achieve at least temporarily a stable circulation.
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PMID:[The use of a percutaneously connected heart-lung machine during resuscitation in cardiogenic shock after acute myocardial infarct]. 811 16