| Alteplase: descendancy in myocardial infarction, ascendancy in stroke. | |
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MedLine Citation:
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PMID: 11772304 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Tissue type plasminogen activator is available, through recombinant technology, for thrombolytic use as alteplase. Alteplase is relatively clot specific and should cause less bleeding side effects than the non-specific agents such as streptokinase. Alteplase has been used successfully in evolving myocardial infarction (MI) to reopen occluded coronary arteries. It is probably equally effective or superior to streptokinase in opening arteries and reducing mortality in MI. Alteplase is most effective when given early in MI and is probably ineffective when given 12 h after the onset of symptoms. The effectiveness of alteplase in MI can be increased by front loading with a bolus of 15 mg, followed by an infusion of 50 mg over 30 min and 35 mg over 60 min. Percutaneous transluminal coronary angioplasty or stenting is associated with a greater patency and lower rates of serious bleeding, recurrent ischaemia and death than alteplase in MI and is likely to take over from alteplase as the standard MI treatment. A reduced dose of alteplase to increase coronary artery patency prior to angioplasty may be useful in MI. An exciting new indication for the use of alteplase is in stroke, where it has become the first beneficial intervention. Alteplase is used to reopen occluded cerebral vessels but is associated with an increased risk of intracerebral haemorrhage. Alteplase is beneficial if given within 3 h of the onset of stroke but not after this time period. Therefore, the next challenge is to increase the percentage of people being diagnosed and treated within this period. Clinical trials have not established a role for alteplase in the treatment of acute coronary syndromes or deep vein thrombosis. However, alteplase is useful in treating pulmonary thromboembolism and peripheral vascular disease. |
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Authors:
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S A Doggrell |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Expert opinion on investigational drugs Volume: 10 ISSN: 1354-3784 ISO Abbreviation: Expert Opin Investig Drugs Publication Date: 2001 Nov |
Date Detail:
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Created Date: 2002-01-04 Completed Date: 2002-03-21 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9434197 Medline TA: Expert Opin Investig Drugs Country: England |
Other Details:
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Languages: eng Pagination: 2013-29 Citation Subset: IM |
Affiliation:
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Department of Physiology and Pharmacology, The University of Queensland, Brisbane, 4072 Queensland, Australia. s_doggrell@yahoo.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Angioplasty, Balloon Clinical Trials as Topic Coronary Disease / drug therapy Fibrinolytic Agents / therapeutic use Humans Myocardial Infarction / drug therapy*, surgery Peripheral Vascular Diseases / drug therapy Plasminogen Activators / administration & dosage, adverse effects, therapeutic use* Pulmonary Embolism / drug therapy Stroke / drug therapy* Tissue Plasminogen Activator / administration & dosage, adverse effects, therapeutic use* Venous Thrombosis / drug therapy |
| Chemical | |
Reg. No./Substance:
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0/Fibrinolytic Agents; EC 3.4.21.-/Plasminogen Activators; EC 3.4.21.68/Tissue Plasminogen Activator |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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