Document Detail

Results of the RAPID 1 and RAPID 2 thrombolytic trials in acute myocardial infarction.
MedLine Citation:
PMID:  11823998     Owner:  NLM     Status:  MEDLINE    
Two angiographic trials, RAPID 1 in 606 patients and RAPID 2 in 324 patients, assessed angiographic patency after acute myocardial infarction following treatment with reteplase and alteplase. RAPID 1 evaluated three bolus regimens of reteplase in comparison with a 3 h infusion of alteplase. RAPID 2 compared the 10 MU + 10 MU double bolus regimen of reteplase with the accelerated regimen (90 min infusion) of alteplase. The results of these studies showed that reteplase opened more arteries more quickly than did alteplase. Angiography at both 60 and 90 min showed a higher rate of patency and greater TIMI (Thrombolysis in Myocardial Infarction perfusion grade) 3 flow rates with reteplase than with alteplase. In RAPID 1, at 90 min, TIMI 3 flow rates were 63% for reteplase compared to 49% for alteplase (P < 0.05), and in RAPID 2, TIMI 3 flow was 60% vs 45%, respectively, (P < 0.05). Reteplase was convenient and simple to administer, and there were no unexpected complications. Fewer interventional procedures were performed after therapy with reteplase than with alteplase, primarily because coronary angioplasty was required less frequently following acute angiography in patients receiving reteplase. The angiographic profile for reteplase demonstrated in these two trials suggests that this new thrombolytic drug has potential advantages over alteplase: notably, its use can result in earlier and more complete coronary patency. The clinical significance of this finding must be determined in larger clinical trials.
W D Weaver
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Publication Detail:
Type:  Clinical Trial; Clinical Trial, Phase II; Journal Article; Multicenter Study; Randomized Controlled Trial    
Journal Detail:
Title:  European heart journal     Volume:  17 Suppl E     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  1996 Sep 
Date Detail:
Created Date:  2002-02-04     Completed Date:  2002-02-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  14-20     Citation Subset:  IM    
Division of Cardiology, University of Washington Medical Center, Seattle, Washington, USA.
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MeSH Terms
Coronary Angiography
Coronary Vessels / physiology
Drug Administration Schedule
Fibrinolytic Agents / therapeutic use*
Infusions, Intravenous
Middle Aged
Myocardial Infarction / drug therapy*,  radiography
Recombinant Proteins / administration & dosage,  therapeutic use*
Regional Blood Flow
Stroke Volume
Time Factors
Tissue Plasminogen Activator / administration & dosage,  therapeutic use*
Treatment Outcome
United States
Reg. No./Substance:
0/Fibrinolytic Agents; 0/Recombinant Proteins; 133652-38-7/reteplase; EC Plasminogen Activator

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