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Impact of tissue plasminogen activator and heparin versus heparin alone on quantitative coronary angiographic findings in myocardial infarction. The Toronto Tissue Plasminogen Activator Trial Study Group.

Publication ,  Journal Article
Haq, A; Morgan, CD; Wilson, RF; Daly, PA; Baigrie, RS; White, CW; Roberts, R; Gent, M; Armstrong, PW
Published in: Am J Cardiol
August 15, 1993

The influence of tissue plasminogen activator (t-PA) and heparin versus heparin alone on anatomic characteristics of patent infarct-related coronary arteries and the development of these angiographic descriptors in coronary arteries that remain patent during the hospital course was examined in 108 patients who participated in a placebo-controlled trial of recombinant tissue-type plasminogen activator in acute myocardial infarction. Coronary angiography was performed 18 +/- 6 hours after treatment in 47 patients (group A) and at 10 days in 61 patients (group B). Quantitative coronary angiography of the infarct-related lesion was performed, and luminal irregularity was quantitated with an ulceration index. Of the 47 patients in group A, 7 (29%) treated with placebo had Thrombolysis in Myocardial Infarction grade 2 or 3 perfusion, whereas 18 (78%) treated with t-PA had grade 2 or 3 (p < 0.001); there was no difference between patients who had grade 2 or 3 perfusion in group B (placebo 59% vs t-PA 75%). In group A, at 10 days, the luminal area of the infarct artery had increased from 0.59 +/- 0.11 to 0.9 +/- 0.24 mm2 and from 0.75 +/- 0.16 to 1.31 +/- 0.39 mm2 for placebo- and t-PA-treated patients, respectively (p < 0.04). There was no change in the ulcerative index over time in either placebo- or t-PA-treated patients. It is concluded that early after infarction, t-PA produces marked and rapid improvement in overall patency as compared with heparin, although this difference was attenuated at 10 days because of spontaneous recanalization in the placebo group.(ABSTRACT TRUNCATED AT 250 WORDS)

Duke Scholars

Published In

Am J Cardiol

DOI

ISSN

0002-9149

Publication Date

August 15, 1993

Volume

72

Issue

5

Start / End Page

379 / 383

Location

United States

Related Subject Headings

  • Vascular Patency
  • Tissue Plasminogen Activator
  • Recombinant Proteins
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
  • Heparin
  • Female
  • Coronary Angiography
 

Citation

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Haq, A., Morgan, C. D., Wilson, R. F., Daly, P. A., Baigrie, R. S., White, C. W., … Armstrong, P. W. (1993). Impact of tissue plasminogen activator and heparin versus heparin alone on quantitative coronary angiographic findings in myocardial infarction. The Toronto Tissue Plasminogen Activator Trial Study Group. Am J Cardiol, 72(5), 379–383. https://doi.org/10.1016/0002-9149(93)91126-3
Haq, A., C. D. Morgan, R. F. Wilson, P. A. Daly, R. S. Baigrie, C. W. White, R. Roberts, M. Gent, and P. W. Armstrong. “Impact of tissue plasminogen activator and heparin versus heparin alone on quantitative coronary angiographic findings in myocardial infarction. The Toronto Tissue Plasminogen Activator Trial Study Group.Am J Cardiol 72, no. 5 (August 15, 1993): 379–83. https://doi.org/10.1016/0002-9149(93)91126-3.
Haq A, Morgan CD, Wilson RF, Daly PA, Baigrie RS, White CW, Roberts R, Gent M, Armstrong PW. Impact of tissue plasminogen activator and heparin versus heparin alone on quantitative coronary angiographic findings in myocardial infarction. The Toronto Tissue Plasminogen Activator Trial Study Group. Am J Cardiol. 1993 Aug 15;72(5):379–383.
Journal cover image

Published In

Am J Cardiol

DOI

ISSN

0002-9149

Publication Date

August 15, 1993

Volume

72

Issue

5

Start / End Page

379 / 383

Location

United States

Related Subject Headings

  • Vascular Patency
  • Tissue Plasminogen Activator
  • Recombinant Proteins
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
  • Heparin
  • Female
  • Coronary Angiography