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Related Experiment Videos

Alteplase: double bolus versus accelerated regimen.

Manuel Ruiz-Bailén1, Eduardo Aguayo de Hoyos, Benjamín Hurtado-Ruiz

  • 1Intensive Care Unit, Critical Care and Emergency Department, Hospital de Poniente, El Ejido, Almería, Spain. mrb1604@teleline.es

Medical Science Monitor : International Medical Journal of Experimental and Clinical Research
|October 22, 2002
PubMed
Summary

Alteplase administration for acute myocardial infarction (AMI) showed similar safety and efficacy between double bolus and accelerated regimens. The accelerated regimen required fewer subsequent interventions like coronary angiography and rescue angioplasty.

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Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Research

Background:

  • Acute myocardial infarction (AMI) treatment often involves thrombolytic therapy.
  • Alteplase is a commonly used thrombolytic agent.
  • Different administration regimens for alteplase exist, including double bolus and accelerated methods.

Purpose of the Study:

  • To compare the efficacy and safety of alteplase in AMI patients.
  • To evaluate two distinct alteplase administration regimens: double bolus versus accelerated.
  • To assess outcomes in an intensive care or coronary care unit (ICU/CCU) setting.

Main Methods:

  • Retrospective cohort study utilizing the ARIAM register (Analysis of Delay in AMI).
  • Inclusion of AMI patients treated with alteplase across 77 Spanish hospitals.

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  • Data collected from January 1995 to January 2000.

    • Main Results:

    • 4,615 AMI patients were analyzed; 57.51% received the accelerated regimen and 42.49% the double bolus regimen.
    • No significant differences in mortality or hemorrhagic stroke incidence were observed between the two groups.
    • The accelerated regimen was associated with significantly fewer coronary angiographies, rescue angioplasties, stent insertions, and intra-aortic balloon counterpulsation assistance.

    Conclusions:

    • Both alteplase administration regimens demonstrate comparable efficacy and safety profiles in AMI.
    • The accelerated regimen appears to reduce the need for subsequent revascularization procedures.
    • Further investigation into revascularization techniques post-double bolus administration may be warranted.