Document Detail


Fibrinolytic agents for the management of ST-segment elevation myocardial infarction.
MedLine Citation:
PMID:  17963464     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Rapid reperfusion is the key treatment goal in patients with ST-segment elevation myocardial infarction (STEMI). The American College of Cardiology-American Heart Association (ACC-AHA) 2004 guidelines for the management of STEMI include recommendations for pharmacologic reperfusion with use of fibrinolytic agents. Fibrinolytic agents are the preferred pharmacologic class for the management of STEMI because of their ability to achieve reperfusion and to restore blood flow when administered within 12 hours of symptom onset. Four fibrinolytic agents are approved for the treatment of STEMI in the United States-streptokinase, alteplase, reteplase, and tenecteplase. Several clinical trials have demonstrated the beneficial effects of these therapies in reducing mortality rates in patients with suspected acute myocardial infarction. Alteplase is administered as an intravenous infusion. However, the relatively long half-lives of reteplase and tenecteplase enable bolus administration, which may be more convenient and less time consuming. Reteplase is administered as a double bolus, and dosing does not depend on the patient's weight; tenecteplase is administered as a single bolus, and dosing is weight based. Adherence to the ACC-AHA guidelines, as well as knowledge about the available fibrinolytic agents, is essential for physicians and pharmacists to make informed decisions regarding appropriate pharmacologic reperfusion strategies.
Authors:
Daniel E Hilleman; James P Tsikouris; A Allen Seals; Jonathan D Marmur
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Pharmacotherapy     Volume:  27     ISSN:  0277-0008     ISO Abbreviation:  Pharmacotherapy     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-10-29     Completed Date:  2007-12-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8111305     Medline TA:  Pharmacotherapy     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1558-70     Citation Subset:  IM    
Affiliation:
Creighton University Cardiac Center, 2500 California Plaza, 3006 Webster Street, Omaha, NE 68131, USA. hilleman@creighton.edu
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Transluminal, Percutaneous Coronary
Clinical Trials as Topic
Electrocardiography
Emergency Medical Services
Fibrin / drug effects,  metabolism
Fibrinolytic Agents / administration & dosage,  pharmacokinetics,  therapeutic use*
Humans
Myocardial Infarction / drug therapy*,  mortality
Myocardial Reperfusion / methods*
Practice Guidelines as Topic
Chemical
Reg. No./Substance:
0/Fibrinolytic Agents; 9001-31-4/Fibrin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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