Accelerated vs. Standard Streptokinase Infusion for Prosthetic Valve Thrombosis

Accelerated infusion was no better than standard infusion at producing complete clinical response.

Left-sided prosthetic valve thrombosis (PVT) is associated with high morbidity and mortality. PVT is relatively common in the developing world, where fibrinolytic therapy is often the first-line treatment. To explore whether increasing the initial fibrinolytic dose would improve outcomes, researchers in India prospectively randomized 120 patients (mean age, 32) with PVT to receive either a standard infusion of streptokinase (0.25 million units [MU] over 30 minutes, followed by 0.1 MU/hour) or an accelerated infusion (1.5 MU over 1 hour, followed, if needed, by 0.1 MU/hour).

At presentation, 72% of the patients had insufficient anticoagulation. The rate of complete clinical response (complete restoration of valve function without death, major…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)