PMID: 2108851Apr 1, 1990Paper

Thrombolytic therapy in acute myocardial infarction

Chest
J D Rutherford, E Braunwald

Abstract

Recombinant tissue-type plasminogen activator (rt-PA), streptokinase (SK), and anisoylated plasminogen-streptokinase activator complex (APSAC) have salutary effects on mortality when administered to patients with evolving acute myocardial infarction (MI). Studies suggest that intravenous rt-PA is more effective in reperfusing occluded infarct-related arteries than SK, and the results of ongoing studies directly comparing the influence of SK and rt-PA on mortality are awaited. The clinical role of agents such as APSAC, urokinase, and pro-urokinase, used alone or in combination, remains to be determined. It is evident that a variety of thrombolytic agents will be effective, and variables such as ease of administration, pharmacokinetics, fibrin specificity, effects on blood viscosity, and incidence of adverse effects need to be assessed to determine which agents are the most suitable for clinical use. There is an increased risk of bleeding at vascular puncture sites with all thrombolytic agents. Current indications for thrombolytic therapy include ischemic chest pain of at least 30 min duration that is unrelieved by nitroglycerin and is associated with ST-segment elevations of at least 0.1 mV in two contiguous electrocardiographic...Continue Reading

Citations

Jun 1, 1996·Protein Science : a Publication of the Protein Society·J FéthièreM Cygler
Sep 24, 2005·Pharmaceutical Research·John S DunnKathleen A Stringer
Nov 15, 1995·Journal of the American College of Cardiology·M A BrouwerF W Verheugt
Aug 29, 1997·International Journal of Cardiology·J C NicolauS A Garzon
Nov 26, 1998·International Journal of Cardiology·B BhargavaS C Manchanda
Jan 29, 2005·Acta Anaesthesiologica Scandinavica·G Bar-JosephUNKNOWN Brain Resuscitation Clinical Trial III (BRCT III) Study Group
Mar 2, 2010·Nihon Rinshō Men'eki Gakkai kaishi = Japanese journal of clinical immunology·Daisuke WakuraToshiaki Hanafusa
Feb 12, 2019·Circulation·Inna Rabinovich-NikitinLorrie A Kirshenbaum

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