Effectiveness of multiple bolus administration of tissue-type plasminogen activator in acute myocardial infarction

The American Journal of Cardiology
M I KhanA Maseri

Abstract

The feasibility and possible advantages of intravenous bolus administration of recombinant tissue-type plasminogen activator (rt-PA) were investigated in 26 consecutive patients with early (less than 6 hours) evolving acute myocardial infarction. Either an intravenous infusion of 40 clot-lysis megaunits (cIMU) double-chain rt-PA over 1.5 hours followed by 20 cIMU over 5 hours (infusion group, n = 12) or 4 intravenous bolus injections of 10 cIMU at 20 minute intervals (bolus group, n = 14) were randomly administered. Coronary arteriography was performed before and at regular predefined intervals up to 90 minutes from the start of rt-PA administration, and at 24 hours. Acute recanalization of the infarct-related coronary artery was demonstrated in 7 of 12 patients (58%; 95% confidence interval 28 to 85%) in the infusion group and 11 of 14 patients (79%; 95% confidence interval 49 to 95%) in the bolus group (difference not significant). Two patients in the bolus group had reoccluded by 24 hours. Mean time from the start of rt-PA to patency of the infarct-related coronary artery was 39 +/- 6 (standard error of the mean) minutes in the infusion group and 28 +/- 6 minutes in the bolus group (p = 0.2). There were no significant differ...Continue Reading

Citations

Jan 1, 1995·Journal of Thrombosis and Thrombolysis·J A Purvis
Jul 4, 1996·The New England Journal of Medicine·R Q MigrinoE J Topol
Jul 25, 1991·The American Journal of Cardiology·B TranchesiM Verstraete
Dec 15, 1991·The American Journal of Cardiology·J A PurvisM M Khan
Dec 1, 1992·The American Journal of Cardiology·J L DiehlH Sors
Jan 1, 1992·The Annals of Pharmacotherapy·S C FaganS Robert

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