Document Detail

Comparative safety of thrombolytic agents.
MedLine Citation:
PMID:  1746450     Owner:  NLM     Status:  MEDLINE    
Three available thrombolytic agents, streptokinase, alteplase, and anistreplase, have been shown to have similar effects on preservation of left ventricular function and mortality reduction after acute myocardial infarction (AMI). The agents are, however, quite different with respect to their safety profiles. Clinical trials to date suggest that alteplase (tissue plasminogen activator) or anistreplase administration is associated with a high incidence of cerebral hemorrhage. In contrast, streptokinase is associated with a low rate of cerebral hemorrhage. Streptokinase and anistreplase are associated with a higher risk of allergic reaction when compared with alteplase. Hypotension is also more common with streptokinase and anistreplase, but occurs significantly with alteplase as well. Alteplase is associated with a lower reinfarction rate when compared with streptokinase and anistreplase. The Third International Study of Infarct Survival (ISIS-3), a direct comparison of 3 thrombolytic agents (streptokinase, anistreplase, and duteplase), may provide some insight regarding the safety of these agents. Because these agents have been shown to be equally effective, selection of an appropriate agent for an individual patient may depend more on assessment of the likelihood of an adverse event or other factors, such as cost or convenience of administration, rather than assessment of the probability of greater benefit with a particular agent.
H D White
Publication Detail:
Type:  Comparative Study; Journal Article; Review    
Journal Detail:
Title:  The American journal of cardiology     Volume:  68     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1991 Dec 
Date Detail:
Created Date:  1992-01-16     Completed Date:  1992-01-16     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  30E-37E     Citation Subset:  AIM; IM    
Cardiovascular Research Unit, Green Lane Hospital, Auckland, New Zealand.
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MeSH Terms
Fibrinolytic Agents / adverse effects*
Thrombolytic Therapy / adverse effects*
Reg. No./Substance:
0/Fibrinolytic Agents

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