Effect of intravenous Urokinase on aged patients with acute myocardial infarction

Objective:To evaluate the efficacy and safety of intravenous Urokinase(UK) on elderly patients(aged70 years as well as ≥60 years) with acute myocardial infarction(AMI).Method:According to the different ages of patients,281 cases of AMI treated with UK were divided into60 years (n=118),60～70 years (n=99) and 70 years (n=64) groups,and the early prognosis of 163 aged patients of them was compared with that of 46 elderly cases in equal term without UK.Result:The patency rate within 3 hours assessed by clinical standard was decreased as the ages of patients were raised(but P 0.05 ),whereas the mortality in 5 weeks and bleeding reactions were increased (all P 0.05 ).In order to prevent UK causing cerebral hemorrhage,intravenous 2 million IU should be avoided in the elderly cases. The mortality in aged patients with thrombolytic therapy was 11.0 % versus 30.4 % in those without (P 0.01 ).Moreover,the incidences of various major complications after treatment were also lower in aged patients undergone thrombolysis,such as left heart failure ( 19.0 % vs 39.1 %,P 0.01 ),cardiogenic shock ( 6.1 % vs 15.2 %,P 0.05 ),severe arrhythmias( 19.0 % vs 32.6 %,P 0.05 ),early postinfarction angina( 8.6 % vs 19.6 %,P 0.05 ) and infarct extension ( 3.1 % vs 10.9 %,P 0.05 ).Conclusion:Thrombolytic therapy with intravenous UK can improve the shortterm outcome of elderly patients(including aged70 years) with AMI.The dosage of UK used should be small.