PMID: 2107237Apr 1, 1990Paper

Improved infarct-related arterial patency after high dose, weight-adjusted, rapid infusion of tissue-type plasminogen activator in myocardial infarction: results of a multicenter randomized trial of two dosage regimens

Journal of the American College of Cardiology
R W SmallingH A Lieberman

Abstract

To determine whether a weight-adjusted high dose (2 mg/kg body weight over 3 h) rapid infusion of recombinant tissue-type plasminogen activator (rt-PA) was more efficacious than a weight-adjusted standard dose (1.25 mg/kg over 3 h) in achieving reperfusion in the setting of acute myocardial infarction, 175 patients were entered into a randomized multicenter trial. Eighty-four patients were entered into the high dose group, receiving 1.2 mg/kg (10% given as a bolus injection) over 1 h, followed by 0.8 mg/kg over the next 2 h. Ninety-one patients were given 0.75 mg/kg (10% given as a bolus injection) in 1 h, followed by 0.5 mg/kg administered over the next 2 h. The median dose in the group that received 2 mg/kg dose was 145 mg, compared with 100 mg in the group that received 1.25 mg/kg. The 90 min patency rate in the group that received 2 mg/kg was 84% compared with 70% in the group that received 1.25 mg/kg (p = 0.003). Sixty-four percent of the patients in each group underwent coronary angioplasty at the time of cardiac catheterization. The infarct-related artery patency rate at the end of catheterization was 91% in the group that received 2 mg/kg compared with 83% in the group that received 1.25 mg/kg (p = 0.08). Among patients...Continue Reading

References

Jun 1, 1987·The Journal of Clinical Investigation·J Loscalzo, D E Vaughan
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Aug 1, 1988·The American Journal of Cardiology·J E DalenG Knatterud

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Citations

Apr 1, 1990·Journal of the American College of Cardiology·E J Topol
Jan 1, 1993·The Journal of Emergency Medicine·S H ThomasE J Allison
Oct 26, 2000·The Journal of Emergency Medicine·D J Moliterno
Dec 5, 1991·The American Journal of Cardiology·H D White
Jan 3, 1992·The American Journal of Cardiology·A J Tiefenbrunn
Nov 5, 1997·American Heart Journal·A H ShandlingY Stavitsky
Feb 7, 2001·Chest·E M OhmanJ W Kennedy
May 12, 1998·Vascular Medicine·C P JuergensS N Oesterle
Sep 1, 1991·Heart & Lung : the Journal of Critical Care·B K Valle, L Lemberg
Jun 1, 1992·Circulation·A J Tiefenbrunn, B E Sobel
Jan 1, 1992·The Annals of Pharmacotherapy·S C FaganS Robert

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