PMID: 2120309Oct 1, 1990Paper

Repeat infusion of recombinant tissue-type plasminogen activator in patients with acute myocardial infarction and early recurrent myocardial ischemia

Journal of the American College of Cardiology
G I BarbashU Seligsohn

Abstract

When conventional treatment of patients with early clinical reinfarction after thrombolytic therapy fails, mechanical revascularization may be attempted. An alternative strategy, repeat thrombolytic infusions, is reported. Fifty-two patients with acute myocardial infarction were treated with one or two additional thrombolytic infusions of recombinant tissue-type plasminogen activator (rt-PA) because of nonsustained ischemia after initial treatment with rt-PA or streptokinase. Thirty-five patients received the second infusion within 1 h of the first; 13 patients received the second infusion 1 to 72 h after the first and 4 patients received it later during their hospitalization. Bleeding complications occurred in 10 patients (19%); however, most of these were minor (no intracranial bleeding) and only 2 patients required blood transfusion. In 14 patients in whom the decrease in fibrinogen and plasminogen levels was measured after the first and second infusions, this decrease was only 25% and 63%, respectively--only slightly higher than the 22% and 53% decreases measured in 63 patients who had only one rt-PA infusion. In 44 patients (85%), the acute ischemia resolved completely within 1 h after initiation of the second infusion. In...Continue Reading

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Citations

Aug 29, 1997·International Journal of Cardiology·B D PrendergastM B Buchalter
Dec 1, 1993·Australian and New Zealand Journal of Medicine·D Cross
Nov 4, 1998·Postgraduate Medical Journal·I R Mahy, K P Jennings
Jan 3, 1992·The American Journal of Cardiology·D W Muller, E J Topol
Jan 3, 1992·The American Journal of Cardiology·A J Tiefenbrunn
Dec 1, 1993·Circulation·M L Simoons, A E Arnold

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