| Repeat infusion of recombinant tissue-type plasminogen activator in patients with acute myocardial infarction and early recurrent myocardial ischemia. | |
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MedLine Citation:
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PMID: 2120309 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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When conventional treatment of patients with early clinical reinfarction after thrombolytic therapy fails, mechanical revascularization may be attempted. An alternative strategy, repeat thrombolytic infusions, is reported. Fifty-two patients with acute myocardial infarction were treated with one or two additional thrombolytic infusions of recombinant tissue-type plasminogen activator (rt-PA) because of nonsustained ischemia after initial treatment with rt-PA or streptokinase. Thirty-five patients received the second infusion within 1 h of the first; 13 patients received the second infusion 1 to 72 h after the first and 4 patients received it later during their hospitalization. Bleeding complications occurred in 10 patients (19%); however, most of these were minor (no intracranial bleeding) and only 2 patients required blood transfusion. In 14 patients in whom the decrease in fibrinogen and plasminogen levels was measured after the first and second infusions, this decrease was only 25% and 63%, respectively--only slightly higher than the 22% and 53% decreases measured in 63 patients who had only one rt-PA infusion. In 44 patients (85%), the acute ischemia resolved completely within 1 h after initiation of the second infusion. In 23 patients (44%), pain and ST segment elevation did not recur and invasive coronary intervention was avoided. Thus, repeat rt-PA infusions can stabilize a substantial number of patients with acute reinfarction and, even when relief is temporary, repeat rt-PA infusions can minimize myocardial damage while patients await mechanical revascularization. |
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Authors:
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G I Barbash; H Hod; A Roth; H E Faibel; Y Mandel; H I Miller; S Rath; Y H Zahav; B Rabinowitz; U Seligsohn |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 16 ISSN: 0735-1097 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 1990 Oct |
Date Detail:
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Created Date: 1990-11-21 Completed Date: 1990-11-21 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 779-83 Citation Subset: AIM; IM |
Affiliation:
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Cardiology Institute, Sheba Medical Center, Tel Aviv, Ramat-Gan, Israel. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Female Hemorrhage / chemically induced Humans Male Middle Aged Myocardial Infarction / drug therapy* Recombinant Proteins / therapeutic use Recurrence Streptokinase / therapeutic use Thrombolytic Therapy* Time Factors Tissue Plasminogen Activator / therapeutic use* |
| Chemical | |
Reg. No./Substance:
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0/Recombinant Proteins; EC 3.4.-/Streptokinase; 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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