PREVENTION OF AN EARLY REOCCLUSION AFTER THROMBOLYTIC THERAPY OF ACUTE MYOCARDIAL-INFARCTION BY KETANSERIN

A problem after successful thrombolytic therapy of acute myocardial infarction is the early occurrence of re-occlusions. An incidence between 10 and 30% is reported. All efforts made so far to reduce the re-occlusion rate using a variety of agents have been disappointing. In a pilot study 20 patients with acute myocardial infarction were treated, in whom a successful lytic therapy with urokinase or rt-PA was documented by means of coronary angiography 90 min after the beginning of treatment. Subsequently the patients were heparinised (thrombin time > 30 s), and in addition the selective serotonin-2 receptor-blocking agent ketanserin was given intravenously (4 mg/h). After 24 h the occurrence of early re-occlusions was investigated by control angiography. None of the 20 patients showed re-occlusions. The degree of stenosis in the infarcted vessel was 72% immediately after lytic therapy, and 68% after 24 h. These preliminary results may suggest a possible reduction in the re-occlusion rate after thrombolytic therapy with a combination of heparin and ketanserin.