| Role of heparin in coronary thrombolysis. | |
| | |
MedLine Citation:
|
PMID: 1555478 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Although the benefits of coronary thrombolysis are well established, the optimal therapeutic strategy for ensuring rapid and sustained coronary artery patency remains controversial. The available data suggest that the success of coronary thrombolysis depends not only on the induction of clot lysis, but also on the extent to which procoagulant activity that promotes recurrent thrombosis is inhibited. Procoagulant activity increases almost immediately in patients treated with fibrinolytic agents, and persistent increases in thrombin activity have been associated with recurrent coronary thrombosis. Heparin administered intravenously appears to markedly attenuate the thrombin activity associated with thrombolysis and, in patients treated with tissue plasminogen activator (t-PA), prevents early recurrent coronary thrombosis. The results of clinical trials of coronary thrombolysis indicate that conjunctive treatment of patients with heparin improves survival compared with treatment with fibrinolytic agents alone. Although recent clinical trials in which patients were treated with streptokinase suggested that 12,500 units of heparin administered subcutaneously twice daily decreases mortality, this dosage regimen does not induce therapeutic levels of anticoagulation within the first 24 h in most patients. The failure to achieve early therapeutic anticoagulation may account for the lack of mortality benefit in trials in which patients given t-PA were treated with conjunctive subcutaneous heparin therapy. Thus, the available experimental and clinical data suggest that intravenous heparin should be given to patients treated with fibrinolytic agents for acute myocardial infarction. |
| | |
Authors:
|
P R Eisenberg |
Related Documents
:
|
11757728 - Acute anterior myocardial infarction as first manifestation of acute myeloid leukemia. 7782728 - Left ventricular thrombosis after anterior myocardial infarction with and without throm... 17463318 - Size matters: hemorrhage volume as an objective measure to define significant intracran... 2889758 - The thrombolysis in myocardial infarction (timi) phase ii pilot study: tissue plasminog... 3956218 - Comparison between ultrasonic and thermodilution cardiac output measurements in intensi... 16376768 - Left atrial appendage flow velocity as a quantitative surrogate parameter for thromboem... |
Publication Detail:
|
Type: Journal Article; Review |
Journal Detail:
|
Title: Chest Volume: 101 ISSN: 0012-3692 ISO Abbreviation: Chest Publication Date: 1992 Apr |
Date Detail:
|
Created Date: 1992-05-07 Completed Date: 1992-05-07 Revised Date: 2005-11-16 |
Medline Journal Info:
|
Nlm Unique ID: 0231335 Medline TA: Chest Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 131S-139S Citation Subset: AIM; IM |
Affiliation:
|
Cardiovascular Division, Washington University School of Medicine, St Louis, MO 63110. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Drug Therapy, Combination Fibrinolysis / drug effects Fibrinolytic Agents / pharmacology, therapeutic use Heparin / pharmacology, therapeutic use* Humans Myocardial Infarction / drug therapy* Thrombolytic Therapy* Treatment Outcome |
| Chemical | |
Reg. No./Substance:
|
0/Fibrinolytic Agents; 9005-49-6/Heparin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Prevention of severe neurologic events in the thrombolytic era.
Next Document: Is survival in acute myocardial infarction related to thrombolytic efficacy or the open-artery hypot...