Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: MONDAY, March 4, 1991 TAG: 9103040184
SECTION: NATIONAL/INTERNATIONAL PAGE: A-6 EDITION: METRO
SOURCE: Associated Press
DATELINE: ATLANTA LENGTH: Medium
The study of some 40,000 patients from nearly 1,000 hospitals in the United States and around the world is the largest and most definitive study yet on the effectiveness of the drugs, said one of the study's directors, Dr. Rory Collins of Oxford University in England.
The results confirm and amplify the findings of a large-scale Italian study reported earlier, and they should help end a high-stakes dispute over which clot dissolver is best, Collins said.
"In terms of mortality, there is no difference," he said.
He discussed the findings Sunday at the annual meeting of the American College of Cardiology.
The key finding, he said, is that giving clot-dissolving drugs after a heart attack "works, and it works in a much wider range of patients than doctors thought."
That includes those over 75 and those who can't be treated until as long as 12 hours after the heart attack begins.
"There's definite benefit out to six hours and probable benefit out to 12 hours and possibly beyond that," he said. And "the benefits of this therapy in patients over 75 are absolutely definite."
"The reason for the emphasis on which is better - it's about money," he said.
The three drugs are streptokinase, a 30-year-old drug, and two newcomers: TPA, a genetically engineered drug, and APSAC, a chemically modified version of streptokinase.
Genentech, which sells TPA in the United States, said the new Oxford trial still does not resolve the question of whether TPA may be better than its far cheaper rival.
Dr. David Stump of Genentech offered two reasons for that contention: The TPA used in the trial is slightly different from Genentech's TPA, and it wasn't given with an intravenous dose of the anticoagulant heparin, which he said increases TPA's effectiveness.
by CNB