Document Detail


Thrombolysis with intravenous human recombinant tissue-type plasminogen activator in acute myocardial infarction: the European experience.
MedLine Citation:
PMID:  2959717     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The initial studies in Europe with tissue-type plasminogen activator (rt-PA) have been coordinated by a European Cooperative Study Group. By February 1987, 258 patients had been entered into comparative coronary patency trials of rt-PA versus streptokinase and rt-PA versus placebo (trials completed and published); 123 patients had entered a coronary patency trial of prolonged rt-PA infusion versus short-term rt-PA infusion (trial completed but results not yet published); and greater than 500 patients had been recruited for left ventricular function and infarct size trials comparing rt-PA with placebo and rt-PA alone with rt-PA plus immediate coronary angioplasty (studies still in progress). The first three studies used two chain rt-PA, 0.75 mg/kg, for the rt-PA versus streptokinase and rt-PA versus placebo studies and 40 or 80 mg for the short-term versus long-term study. The current studies are using single chain rt-PA in a dose of 100 mg (20 mg bolus, 40, 20 and 20 mg in succeeding hours). Coronary patency at angiography 90 minutes after the start of treatment was 70% for rt-PA and 55% for streptokinase, 1.5 million units, in the plasminogen activator versus streptokinase study (p = 0.054), 61% for rt-PA and 21% for placebo in the rt-PA versus placebo study (p less than 0.001). In the first three studies (251 patients allocated to rt-PA) there was one case of retroperitoneal hematoma, one of hematemesis and no cases of cerebral hemorrhage; 38 patients (15%) had a hematoma or bleeding related to arterial catheterization.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
D P de Bono
Related Documents :
1951107 - Initial treatment of patients with acute ischemic heart disease hospitalized in a commu...
10608017 - Efficacy and safety of low-dose streptokinase plus desmopressin in acute myocardial inf...
12222987 - Myocardial infarction in the elderly: benefits and risks of thrombolytics.
7758177 - More rapid, complete, and stable coronary thrombolysis with bolus administration of ret...
2389687 - Evidence for a role of platelet activating factor in the pathogenesis of irreversible b...
3704697 - Myocardial damage and electrical injuries: significance of early elevation of cpk-mb is...
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  10     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1987 Nov 
Date Detail:
Created Date:  1987-12-04     Completed Date:  1987-12-04     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  75B-78B     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Royal Infirmary, Edinburgh, Scotland, United Kingdom.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Angioplasty, Balloon
Clinical Trials as Topic
Combined Modality Therapy
Coronary Angiography
Double-Blind Method
Europe
Humans
Infusions, Intravenous
Myocardial Infarction / drug therapy*
Placebos
Recombinant Proteins / administration & dosage,  adverse effects
Streptokinase / administration & dosage
Time Factors
Tissue Plasminogen Activator / administration & dosage*,  adverse effects
Vascular Patency / drug effects
Chemical
Reg. No./Substance:
0/Placebos; 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


Previous Document:  Thrombolysis and Angioplasty in Myocardial Infarction (TAMI) trial.
Next Document:  A cost-effectiveness model for coronary thrombolysis/reperfusion therapy.