Molecular biology of plasminogen activators: what are the clinical implications of drug design?

The American Journal of Cardiology
R W Smalling

Abstract

The initial work on thrombolytic therapy for acute myocardial infarction (AMI) focused on intracoronary administration of streptokinase. Continuing research has given rise to the development of both second- and third-generation agents and consequent refinements in thrombolytic regimens. Intravenous recombinant tissue plasminogen activator (t-PA, or alteplase) proved superior to both intracoronary and intravenous streptokinase with regard to reperfusion efficacy and impact on survival. An accelerated dosage regimen was later devised to allow the administration of t-PA over a shorter period of time. Unfortunately, t-PA failed to lessen the risk of bleeding complications that had plagued the use of streptokinase. The wild-type t-PA molecule has since been modified in an attempt to achieve improved lytic characteristics with less bleeding risk. Among these third-generation agents is reteplase (r-PA); compared with alteplase, reteplase has a prolonged half-life and seems to offer more rapid thrombolysis. Promising results have been obtained in large, randomized trials of reteplase. Another new agent is the TNK mutant of t-PA, which also has a prolonged half-life and seems to produce more rapid and complete thrombolysis, as well as l...Continue Reading

References

Sep 1, 1991·Progress in Cardiovascular Diseases·D CollenH K Gold
Nov 15, 1989·Journal of the American College of Cardiology·K L NeuhausU Tebbe
Aug 1, 1988·The American Journal of Cardiology·J E DalenG Knatterud
Apr 26, 1994·Proceedings of the National Academy of Sciences of the United States of America·B A KeytJ Ogez
Sep 2, 1993·The New England Journal of Medicine·UNKNOWN GUSTO investigators
Nov 1, 1993·Journal of the American College of Cardiology·T LindererJ Wagner
Mar 11, 1993·The New England Journal of Medicine·F ZijlstraH Suryapranata

❮ Previous
Next ❯

Citations

Jun 1, 2004·Seminars in Interventional Radiology·Thuong Van Ha
Mar 20, 1999·Clinical Cardiology·A M Ross
Jun 13, 2001·Pharmacotherapy·S A Spinler, S M Inverso
Oct 14, 2000·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·A I QureshiL N Hopkins
May 26, 2015·Journal of Atherosclerosis and Thrombosis·Zhiqiang ZhangYunlu Xu
Mar 14, 2007·Annals of Vascular Surgery·Hugh A GelabertDavid A Rigberg
Oct 30, 2007·Pharmacotherapy·Daniel E HillemanJonathan D Marmur
Nov 20, 2002·Expert Opinion on Investigational Drugs·Paul A Lapchak
Nov 9, 2001·Journal of Vascular Surgery·C K ShortellR M Green
Apr 15, 2006·Journal of Vascular and Interventional Radiology : JVIR·Jeffrey Eaton HullH Andy Park
Jan 25, 2017·Frontiers of Medicine·Melvin E Klegerman
Mar 22, 2000·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·O IqbalW Wehrmacher
Apr 30, 2016·Circulation Research·Charlotte ZernaMichael D Hill
Mar 17, 2011·The Biochemical Journal·Charles S CraikEdwin L Madison
Feb 9, 2007·Expert Review of Neurotherapeutics·Rishi Gupta, Tudor G Jovin
Apr 14, 1999·The Annals of Pharmacotherapy·M B Wooster, A B Luzier
May 8, 2018·Acta neurologica Belgica·A ThelenganaKameshwar Prasad

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiovascular Diseases: Risk Factors

Cardiovascular disease is a significant health concern. Risk factors include hypertension, obesity, dyslipidemia and smoking. Women who are postmenopausal are at an increased risk of heart disease. Here is the latest research for risk factors of cardiovascular disease.