PMID: 11337927May 8, 2001Paper

Usefulness of combination therapy of hybrid thrombolysis followed by back-up percutaneous transluminal coronary angioplasty in patients with acute myocardial infarction

Journal of cardiology
H MukawaH Imai

Abstract

Conventional thrombolytic therapy for acute myocardial infarction is effective for early reperfusion but has the disadvantage of a higher rate of bleeding complications. The purpose of this study is to elucidate efficacy and safety of a combined approach using a bolus injection of low dose of mutant tissue plasminogen activator (mt-PA) with heparin and aspirin to ensure definite antithrombin and antiplatelet efficacy, followed by back-up percutaneous transluminal coronary angioplasty(PTCA). Patients with acute myocardial infarction aged < 80 years who were admitted to our institution within 3 hr of onset of symptoms were immediately treated with oral aspirin 330 mg and intravenous heparin 5,000 IU and were randomized to receive an intravenous bolus of mt-PA (monteplase) 15,000 IU/kg (thrombolytic group, n = 25) or no mt-PA (control group, n = 21), followed by angiography with PTCA if indicated. There were no differences between the two groups in patient characteristics, time from onset to hospital arrival, time to initial angiography, or infarct-related arteries. Significantly more patients had Thrombolysis in Myocardial Infarction flow grade 3 and grade 2/3 at the initial angiography in the thrombolytic group than in the contr...Continue Reading

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