Symposium on Anisoylated Plasminogen
Streptokinase Activator Complex (APSAC)
Proceedings of an international symposium sponsored by
Beecham Pharmaceuticals held in Guernsey on 5-6 November,
1986
Guest Editors
J.L. Anderson
J.-P. Boissel
D.A. Chamberlain
Technical Editors
Jon P. Monk
Deborah M. Campoli-Richards
Alan Ward
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Drugs
Contents Vol. 33, Supplement 3, 1987
ix-xi
List of Contributors
Section 1: Introduction to Thrombolysis in Acute Myocardial Infarction
1-12
S. Sherry
Thrombolytic Therapy in Acute Myocardial Infarction: A Perspective
13-21
V.J. Marder and C. W. Francis
Physiological Balance of Haemostasis and Bleeding
22-32
J.L. Anderson
.
Recent Clinical Developments in Thrombolysis in Acute Myocardial Infarction
33-50
H. Ferres
Preclinical Pharmacological Evaluation of Anisoylated Plasminogen Streptokinase
Activator Complex
Poster Presentations
51-56
R. Fears, H. Ferres and R. Standring
Evidence for the Progressive Uptake of Anisoylated Plasminogen Streptokinase Activator
Complex by Clots in Human Plasma in Vitro (Short Communication)
57-63
R. Fears, H. Ferres and R. Standring
The Protective Effect of Acylation on the Stability of Anisoylated Plasminogen Streptokinase
Activator Complex in Human Plasma (Short Communication)
64-68
R. Fears, H. Ferres, M. Hibbs and R. Standring
Consequences of Antibody Binding in Vitro on the Pharmacological Properties of
Anisoylated Plasminogen Streptokinase Activator Complex (Short Communication)
69-74
R. Fears
The Effect of Heparin arid Fibrin on the Enzymatic Efficiencies of Thrombolytics in Vitro
(Short Communication)
75-79
R.A.G. Smith
Non-Exchange of Streptokinase from Anisoylated Plasminogen Streptokinase Activator
Complex and Other Acylated Streptokinase-Plasminogen Complexes (Short Communication)
80-82
H. Ferres, M. Hibbs and R.A.G. Smith
Deacylation Studies in Vitro on Anisoylated Plasminogen Streptokinase Activator Complex
(Short Communication)
83-87
R. Fears
Evidence for a Sustained Fibrinolytic Response to Anisoylated Plasminogen Streptokinase
Activator Complex in Vitro (Short Communication)
88-92
B. Nunn, A. Esmail, R. Fears, H. Ferres and R. Standring
Pharmacokinetic Properties of Anisoylated Plasminogen Streptokinase Activator Complex
and Other Thrombolytic Agents in Animals and in Humans (Short Communication)
93-96
C.J. Banton and B.G. Overell
Fibrin Binding: An Essential Property of Anisoylated Plasminogen Streptokinase
Activator Complex
97-101
J.A. Artus, A. Cockburn, J. Fuller, A.S. McMurdo and D.J. White
The Preclinical Toxicology of Anisoylated Plasminogen Streptokinase Activator Complex
102-103 Discussion: Section 1
Section 2: Efficacy of Anisoylated Plasminogen Streptokinase Activator Complex:
Evidence of Vessel Patency
104-111
D.Jackson
Summary of Early Clinical Experience with Anisoylated Plasminogen Streptokinase Activator
Complex in the Treatment of Acute Myocardial Infarction
112-116
W. Kasper, Th. Meinertz, H. Wollschldger, T. Bonzel, C. Chen, T. Hofmann, A'. Zeiher,
H. Drexler and H. Just
Early Clinical Evaluation of the Intravenous Treatment of Acute Myocardial Infarction with
Anisoylated Plasminogen Streptokinase Activator Complex
117-123
W.S. Hillis, R.S. Hornung, K.J. Hogg, N. Hockings, J.M.A. Bums and F.G. Dunn
Achievement of Coronary Artery Patency by Use of Anisoylated Plasminogen Streptokinase
Activator Complex in Acute Myocardial Infarction
124-132
V.J. Marder, R.L. Rothbard, P.G. Fitzpatrick, C.W. Francis and E.C. Norry
Dose-Ranging Studies of Anisoylated Plasminogen Streptokinase Activator Complex:
Studies in Healthy Volunteers and in Patients with Acute Myocardial Infarction
133-137 A. Leizorovicz, G. Durrieu and J.-P. Boissel (on behalf of the APSAC Research Group)
A Randomised Placebo-Controlled Pilot Dose-Response Study with Anisoylated Plasminogen
Streptokinase Activator Complex in Acute Coronary Artery Occlusions
138-139
D.P.deBono
A Placebo-Controlled Patency Study of Intravenous Anisoylated Plasminogen Streptokinase
Activator Complex 30U in Acute Myocardial Infarction (Short Communication)
140-145 M.L. Brochier, L. Quilliet, H. Kulbertus, P. Materne, B. Letac, A. Cribier, J.P. Monassier,
A. Sacrez and J.P. Favier
Intravenous Anisoylated Plasminogen Streptokinase Activator Complex versus Intravenous
Streptokinase in Evolving Myocardial Infarction: Preliminary Data from a Randomised
Multicentre Study
146-150 A.D. Timmis, B. Griffin, J.C.P. Crick, J.S. Flax and E. Sowton
An Interim Report of a Double-Blind Placebo-Controlled Recanalisation Study of
Anisoylated Plasminogen Streptokinase Activator Complex in Acute Myocardial Infarction
151-153 J.J.R.M. Bonnier (Report of the Dutch Multicentre Invasive Reperfusion Study Group)
Comparison of Intravenous Anisoylated Plasminogen Streptokinase Activator Complex with
Intracoronary Streptokinase in Acute Myocardial Infarction
154-162
J.L.Anderson
Reperfusion in Acute Myocardial Infarction: A Multicentre Randomised Trial of Early
Intracoronary Streptokinase and Intravenous Anisoylated Plasminogen Streptokinase
Activator Complex in the United States
Poster Presentations
163-168 S.G. Sorensen, R.A. Hackworthy, P.G. Fitzpatrick, W.H. Barry, R.L. Menlove and
J.L. Anderson (for the APSAC Multicenter Investigators)
Acute Coronary Occlusion and Reperfusion: Reliability of Angiographic Classification
and Grading
169-174 R. Seabra-Gomes, 7. Aniceto Silva, A. Aleixo, T. Real, I. Freire, I. Torres, R. Freitas and
F. Crespo
Evaluation of 2 Intravenous Thrombolytic Agents (Anisoylated Plasminogen Streptokinase
Activator Complex versus Streptokinase) in Patients with Acute Myocardial Infarction
•
•
v •
175-178 P. Monnier, U. Sigwart, A. Vincent, F. Bachmann, J.J. Goy, M.-D. Schaller, U. Kaufmann,
M. Badan, M. Grbic, C. Perret and L. Kappenberger
Anisoylated Plasminogen Streptokinase Activator Complex versus Streptokinase in Acute
Myocardial Infarction: Preliminary Results of a Randomised Study
179-182 L. Kaspar, R. Karnik, E. Sehnal, P. Zajicek, B. Ziegler and /. Slany
Intracoronary Streptokinase versus Intravenous Anisoylated Plasminogen Streptokinase
Activator Complex in the Treatment of Acute Myocardial Infarction
183-185 P. Hellstern, P. Doenecke, M. Kohler, H. Schwerdt, C. Ozbek, C. Miyashita, L. Bette and
E. Wenzel
Intravenous Bolus Application of Streptokinase and of Anisoylated Plasminogen
Streptokinase Activator Complex in Acute Myocardial Infarction: Clinical and
Haemostaseological Findings (Short Communication)
186-188 S.J. Lenhoff, A.R. Horak, R.C. Fraser, R.N. Scott-Millar, A.R. Bird, P. Jacobs and
P.J. Commerford
Evaluation of the Efficacy and Safety of Anisoylated Plasminogen Streptokinase Activator
Complex in Early Myocardial Infarction: Preliminary Results (Short Communication)
189-190 Discussion: Section 2
Section 3: Efficacy of Anisoylated Plasminogen Streptokinase Activator Complex:
Evidence of Myocardial Function and Mortality Benefit
191-197 M. Been, A.L. Muir and D.P. de Bono
Left Ventricular Function after Anisoylated Plasminogen Streptokinase Activator Complex
198-208 R.A. Hack-worthy, S.G. Sorensen, R.L. Menlove and J.L. Anderson (for the APSAC
Multicenter Investigators)
Electrocardiographic and Enzymatic Infarct Size in a Randomised Study of Intracoronary
Streptokinase and Intravenous Anisoylated Plasminogen Streptokinase Activator Complex in
Acute Myocardial Infarction
209-215 M.B. Buchalter, J.P. Bourke, K.P. Jennings, PC. Adams, A.C.F. Kenmure, Chan Wah Hah
and D.S. Reid
The Effect of Thrombolytic Therapy with Anisoylated Plasminogen Streptokinase Activator
Complex on the Indicators of Myocardial Salvage
216-220
Y. Taeymans and P. Materne [on behalf of the Belgian Group of the European Multicentre
Study (EMS)]
Assessment of Left Ventricular Function in a Randomised Study of Intravenous Anisoylated
Plasminogen Streptokinase Activator Complex versus Heparin in Acute Myocardial
Infarction: Preliminary Results of the European Multicentre Study (Belgian Centres)
221-222 D.A. Chamberlain
Treatment of Acute Myocardial Infarction with Anisoylated Plasminogen Streptokinase
Activator Complex in a District Hospital: Efficacy Data (Short Communication)
223-226
Th. Meinertz and W. Kasper (on behalf of the German Eminase Study Group)
Randomised Multicentre Trial of Anisoylated Plasminogen Streptokinase Activator Complex
versus Heparin: Interim Results (Short Communcation)
Poster Presentations
227-228 UK APSAC Advisory Committee
AIMS: The Design and Conduct of a Multicentre Mortality Study Comparing Placebo and
Anisoylated Plasminogen Streptokinase Activator Complex 30U Intravenously for the
Treatment of Acute Myocardial Infarction of Less than 6 Hours Duration
(Short Communication)
229-230 UK APSAC Advisory Committee
Should We Intervene Following Thrombolytic Therapy?: The SWIFT Study in Progress
(Short Communication)
231-234 A.D. Castaigne, A.M. Duval, J.L. Dubois-Rande, C. Herve, F. Jan and Y. Louvard
Prehospital Administration of Anisoylated Plasminogen Streptokinase Activator Complex in
Acute Myocardial Infarction
235-236 Discussion: Section 3
Section 4: Anisoylated Plasminogen Streptokinase Activator Complex and Haematological
Parameters
Comparative Invasive Trials
237-241
V.J. Marder, P.A. Kinsella and M.J. Brown
Fibrinogen Concentration and Coronary Artery Reperfusion after Intravenous Anisoylated
Plasminogen Streptokinase Activator Complex or Intracoronary Streptokinase Therapy
242-246 J.J.M.L. Hoffmann, J.J.R.M. Bonnier, J.B.R.M. de Swart, P. Custers and M. Vijgen
Systemic Effects of Anisoylated Plasminogen Streptokinase Activator Complex and
Streptokinase Therapy in Acute Myocardial Infarction: Coagulation Aspects of the Dutch
Invasive Reperfusion Study
247-252 J.-P. Monassier (on behalf of the IRS II Study Group) and M. Hanssen
Haematological Effects of Anisoylated Plasminogen Streptokinase Activator Complex and
Streptokinase in Patients with Acute Myocardial Infarction: Interim Report of the IRS II
Study
Comparative Non-Invasive Trials
253-260 J. Renkin, C. Col-De Beys, E. Lavenne-Pardonge, H. Pintens and /. Col [on behalf of the
Belgian Group of the European Multicentre Study (EMS)]
Analysis of Coagulation and Fibrinolysis after Intravenous Anisoylated Plasminogen
Streptokinase Activator Complex or Heparin in Patients with Acute Myocardial Infarction:
A Belgian Multicentre Study
261-267 D.G. Julian, L.S. Borthwick, D. Reid, K.P. Jennings, R.J. Wainwright, J.C. Rodger, D. Wood
and W.S. Phillips
Anisoylated Plasminogen Streptokinase Activator Complex versus Placebo: A Preliminary
Multicentre Study of Safety and Early Mortality in Acute Myocardial Infarction
268-274 M. Samama, J. Conard, E. Verdy, P. Van Dreden, G. Nguyen, A. Combrisson and J. Acar
Biological Study of Intravenous Anisoylated Plasminogen Streptokinase Activator Complex
in Acute Myocardial Infarction
275
Discussion: Section 4
Section 5: Safety and Tolerance Data
Comparative Invasive Trials
276-278
R.L.
Rothbard
Comparative Tolerance and Complications in a Multicentre Trial of Intracoronary
Streptokinase and Intravenous Anisoylated Plasminogen Streptokinase Activator Complex
in Acute Myocardial Infarction
279-281 J.B.R.M. de Swart
Comparison of the Safety and Tolerance of Intravenous Anisoylated Plasminogen
Streptokinase Activator Complex and Intracoronary Streptokinase in Acute Myocardial
Infarction (Short Communication)
282-285 J.-P. Monassier (on behalf of the IRS II Study Group) and M. Hanssen
Safety and Side Effects of Anisoylated Plasminogen Streptokinase Activator Complex
and Streptokinase in Patients with Acute Myocardial Infarction: Interim Report of the
IRS II Studv
Comparative Non-Invasive Trials
286
D.A. Chamberlain
Treatment of Acute Myocardial Infarction with Anisoylated Plasminogen Streptokinase
Activator Complex in a District Hospital: Tolerance Data (Short Communication)
287-292 L.L. Bossaert [on behalf of the Belgian Group of the European Multicentre Study (EMS)]
Safety and Tolerance Data from the Belgian Multicentre Study of Anisoylated Plasminogen
Streptokinase Activator Complex versus Heparin in Acute Myocardial Infarction
293-296 E.A.P. Croydon [on behalf of the French Group of the European Multicentre Study (EMS)]
Preliminary Safety and Tolerance Data Obtained in the Comparative Study of Anisoylated
Plasminogen Streptokinase Activator .Complex versus Heparin
297
Discussion: Section 5
Section 6: Anisoylated Plasminogen Streptokinase Activator Complex in Perspective
298-311 E.S. Johnson and R.J. Cregeen
An Interim Report of the Efficacy and Safety of Anisoylated Plasminogen Streptokinase
Activator Complex (APSAC)
312-316
Panel Discussion