Thrombolysis and coronary occlusion: effects upon the non-infarct zone

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Updated: Jun 27, 2026

Myocardial Infarction and Functional Outcome Assessment in Pigs
12:03

Myocardial Infarction and Functional Outcome Assessment in Pigs

Published on: April 25, 2014

R Cranswick1, G Carter, N Wilkes

  • 1TICO Working Group, Royal North Shore Hospital, St Leonards, Sydney, Australia.

European Heart Journal
|June 1, 1992
PubMed

Insights

Recombinant tissue plasminogen activator (rt-PA) improved coronary artery patency and preserved left ventricular ejection fraction compared to placebo in the TICO Trial. This treatment was particularly effective for the left anterior descending artery.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Thrombolytic Therapy

Background:

  • Myocardial infarction (MI) remains a leading cause of mortality.
  • Early reperfusion therapy is crucial for improving outcomes in acute MI.
  • Assessing the impact of thrombolytic agents on regional myocardial function is essential.

Purpose of the Study:

  • To evaluate the efficacy of recombinant tissue plasminogen activator (rt-PA) in improving coronary patency and left ventricular function post-MI.
  • To compare the effects of rt-PA versus placebo on regional wall motion and left ventricular ejection fraction (LVEF).
  • To identify patient subgroups that benefit most from rt-PA therapy.

Main Methods:

  • The Thrombolysis in Coronary Occlusion (TICO) Trial enrolled 154 patients with acute MI.
  • Regional wall motion was assessed by angiography 3 weeks after treatment.
  • Patients received either rt-PA or a placebo.

Main Results:

  • Coronary patency rates were significantly higher with rt-PA (81%) compared to placebo (64%) (P=0.02).
  • rt-PA administration preserved LVEF (59% vs 53%, P=0.01) due to enhanced non-infarct zone contraction.
  • The left anterior descending artery showed better patency with rt-PA (96%) than the right coronary artery (70%).

Conclusions:

  • rt-PA significantly improves coronary artery patency and preserves left ventricular function after MI.
  • The benefits of rt-PA are most pronounced in patients with single-vessel disease and LAD occlusions.
  • Enhanced non-infarct zone contraction is a key mechanism for preserved LVEF following rt-PA treatment.

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