Recombinant tissue-type plasminogen activator followed by heparin compared with heparin alone for refractory unstable angina pectoris

The American Journal of Cardiology
D ArdissinoG Specchia


Patients with unstable angina pectoris who remain symptomatic despite medical treatment are at high risk of death and myocardial infarction. The incidence of refractory unstable angina was examined in a consecutive series of 103 patients who received conventional medical treatment with nitrates, beta blockers, calcium antagonists and aspirin. During 48 hours of continuous electrocardiographic monitoring, 24 patients had greater than or equal to 1 anginal attack, 5 of whom had both painful and painless ischemic episodes. In these 24 patients with unstable angina refractory to conventional medical treatment, the short-term efficacy of recombinant tissue-type plasminogen activator (rt-PA) followed by heparin was assessed and compared with heparin alone in a randomized double-blind trial. Recurrences of ischemic attacks during a 72-hour follow-up period were documented in 9 of the 12 patients given heparin alone. All patients experienced at least 1 symptomatic ischemic episode and 1 patient had both painful and painless ischemia. No patient given rt-PA plus heparin had either symptomatic or asymptomatic ischemic attacks during follow-up. Kaplan-Meier curves analysis demonstrated a significantly higher probability of being ischemia ...Continue Reading


Aug 1, 1979·American Heart Journal·G D Plotnick
Feb 1, 1989·Journal of the American College of Cardiology·J M NicklasB Pitt
Oct 27, 1988·The New England Journal of Medicine·P ThérouxP deGuise
Aug 1, 1988·Journal of the American College of Cardiology·C de ZwaanH J Wellens
Aug 8, 1985·The New England Journal of Medicine·P J de FeyterP G Hugenholtz
Oct 9, 1986·The New England Journal of Medicine·C T ShermanL Morgenstern
May 1, 1987·Journal of the American College of Cardiology·J A AmbroseV Fuster
Mar 15, 1980·Thrombosis Research·J R LawrenceW F Fulton
Jul 1, 1983·The American Journal of Cardiology·J B MandelkornS G Meister
May 3, 1984·The New England Journal of Medicine·M J Davies, A Thomas
Sep 22, 1983·The New England Journal of Medicine·A MoiseM G Bourassa


Sep 1, 1993·Clinical Cardiology·S BorzakM Lesch
Nov 1, 1994·Journal of the American College of Cardiology·P T Vaitkus, W K Laskey
Nov 15, 1994·Journal of the American College of Cardiology·F W BarH J Wellens
Dec 4, 1992·Annals of the New York Academy of Sciences·E Falk
Nov 28, 2013·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Fabio AngeliClaudio Cavallini
Sep 3, 1991·The American Journal of Cardiology·M L BrochierG Pacouret
Mar 1, 1993·Current Problems in Cardiology·P Théroux, R M Lidón
Sep 1, 1993·International Journal of Cardiology·D H Israel, J A Ambrose
Nov 4, 1991·The American Journal of Cardiology·D D WatersP Théroux
Nov 1, 1992·Circulation·T L SchreiberA Margulis
Nov 1, 1992·Circulation·D D Waters, J Y Lam
Feb 1, 1996·Italian Journal of Neurological Sciences·L CandeliseA P Maggioni

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