Clot-selective coronary thrombolysis with lowdose synergistic combinations of single-chain urokinase-type plasminogen activator and recombinant tissue-type plasminogen activator
| Autor: | Joseph Loscalzo, Eric J. Topol, Victor Gurewich, Richard R. Schumacher, Herbert J. Levine, Eugene Braunwald, James M. Kirshenbaum, Raymond D. Bahr, John T. Flaherty, Dennis W. Wahr |
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| Rok vydání: | 1991 |
| Předmět: |
Intracerebral hemorrhage
Urokinase medicine.medical_specialty business.industry medicine.medical_treatment Thrombolysis medicine.disease Tissue plasminogen activator Coronary thrombosis Internal medicine Fibrinolysis medicine Cardiology Myocardial infarction Cardiology and Cardiovascular Medicine business Plasminogen activator medicine.drug |
| Zdroj: | The American Journal of Cardiology. 68:1564-1569 |
| ISSN: | 0002-9149 |
| DOI: | 10.1016/0002-9149(91)90310-h |
| Popis: | The effect of simultaneous infusions of low-dose recombinant tissue-type plasminogen activator (t-PA) and single-chain urokinase-type plasminogen activator (scu-PA, pro-urokinase) on coronary arterial thrombolysis was investigated in 23 patients treated within 6 hours (mean 2.6 +/- 1.1, range 1.2 to 5.9) of symptoms of an acute myocardial infarction. Infarct artery patency at 90 minutes was achieved in 16 (70%, 95% confidence limits of 0.47 to 0.87) of 23 patients after a 1-hour intravenous infusion of 20 and 16.3 mg of t-PA and scu-PA, respectively. At 90 minutes, the fibrinogen concentration decreased from 369 +/- 207 to 316 +/- 192 mg/dl (p = not significant), while plasminogen decreased to 69 +/- 24% (p = 0.001) and alpha-2-antiplasmin to 77 +/- 24% (p = 0.001) of pretreatment values. Although no bleeding requiring termination of drug infusion or transfusion occurred, 1 patient with cerebrovascular amyloidosis had a fatal intracerebral hemorrhage. These findings suggest that combination therapy may allow substantial reductions in total thrombolytic doses while still achieving effective fibrin-specific coronary thrombolysis. |
| Databáze: | OpenAIRE |
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