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Thrombolytic Therapy for Acute Myocardial Infarction : A Review.

Publication ,  Journal Article
Granger, CB; Califf, RM; Topol, EJ
Published in: Drugs
September 1992

In the past 10 years, thrombolytics have become standard therapy for acute myocardial infarction. Although the ability of streptokinase to lyse clot was first recognised in the 1930s, thrombolytic therapy was not used to treat acute myocardial infarction until the early 1980s, when the importance of thrombosis in the pathogenesis of acute infarction was fully recognised.In addition to streptokinase and urokinase, recombinant human tissue plasminogen activator (tPA) and anistreplase were developed and widely used in the 1980s. Saruplase (prourokinase) and BM-06022 (recombinant plasminogen activator) have also undergone human clinical studies. All of these agents are effective at achieving clot lysis and coronary patency. Large, randomised clinical trials have demonstrated that thrombolytic therapy reduces mortality in patients with ST elevation treated within the first 6 to 12 hours of acute infarction, with an approximately 0.5% risk of intracranial haemorrhage. Recent data have more clearly identified which patients benefit from thrombolytic therapy.Efforts have been made to improve the speed of reperfusion, decrease reocclusion, simplify administration and reduce adverse effects. The characteristics of fibrin specificity and more rapid clot lysis with tissue plasminogen activator have not yet been translated into overall clinical benefit compared with the less expensive streptokinase. The lack of close association of improved early patency and improved global left ventricular function with improved survival challenges the very paradigm which led to the use of thrombolytic therapy for acute myocardial infarction. The need for development of additional methods for evaluation of new thrombolytic agents is evident.

Duke Scholars

Published In

Drugs

DOI

EISSN

1179-1950

Publication Date

September 1992

Volume

44

Issue

3

Start / End Page

293 / 325

Location

New Zealand

Related Subject Headings

  • Thrombolytic Therapy
  • Pharmacology & Pharmacy
  • Myocardial Infarction
  • Humans
  • 3214 Pharmacology and pharmaceutical sciences
  • 3202 Clinical sciences
  • 1115 Pharmacology and Pharmaceutical Sciences
 

Citation

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ICMJE
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Granger, C. B., Califf, R. M., & Topol, E. J. (1992). Thrombolytic Therapy for Acute Myocardial Infarction : A Review. Drugs, 44(3), 293–325. https://doi.org/10.2165/00003495-199244030-00002
Granger, Christopher B., Robert M. Califf, and Eric J. Topol. “Thrombolytic Therapy for Acute Myocardial Infarction : A Review.Drugs 44, no. 3 (September 1992): 293–325. https://doi.org/10.2165/00003495-199244030-00002.
Granger CB, Califf RM, Topol EJ. Thrombolytic Therapy for Acute Myocardial Infarction : A Review. Drugs. 1992 Sep;44(3):293–325.
Granger, Christopher B., et al. “Thrombolytic Therapy for Acute Myocardial Infarction : A Review.Drugs, vol. 44, no. 3, Sept. 1992, pp. 293–325. Pubmed, doi:10.2165/00003495-199244030-00002.
Granger CB, Califf RM, Topol EJ. Thrombolytic Therapy for Acute Myocardial Infarction : A Review. Drugs. 1992 Sep;44(3):293–325.
Journal cover image

Published In

Drugs

DOI

EISSN

1179-1950

Publication Date

September 1992

Volume

44

Issue

3

Start / End Page

293 / 325

Location

New Zealand

Related Subject Headings

  • Thrombolytic Therapy
  • Pharmacology & Pharmacy
  • Myocardial Infarction
  • Humans
  • 3214 Pharmacology and pharmaceutical sciences
  • 3202 Clinical sciences
  • 1115 Pharmacology and Pharmaceutical Sciences