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Importance of the pharmacological profile of thrombolytic agents in clinical practice

J S Alpert1

  • 1Division of Cardiovascular Medicine, University of Massachusetts Medical School and Center, Worcester 01655.

The American Journal of Cardiology
|December 5, 1991
PubMed

Insights

This study compares four thrombolytic agents for acute myocardial infarction: streptokinase, alteplase (t-PA), anistreplase (APSAC), and urokinase. Differences in pharmacologic properties like half-life and clot specificity influence clinical use.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Acute myocardial infarction (AMI) treatment often involves thrombolytic agents.
  • Commonly used agents include streptokinase, alteplase (t-PA), and anistreplase (APSAC).
  • Urokinase is used less frequently with limited clinical experience.

Purpose of the Study:

  • To compare the pharmacologic properties of commonly used thrombolytic agents for AMI.
  • To highlight how differences in properties like half-life and fibrin affinity impact clinical application.

Main Methods:

  • Review of pharmacologic properties of streptokinase, alteplase, and anistreplase.
  • Comparison of half-life, enzymatic efficiency, and platelet aggregation induction.
  • Assessment of fibrin affinity and clot specificity.

Main Results:

  • Agents exhibit varied pharmacologic profiles, including half-life and enzymatic efficiency.
  • Anistreplase and alteplase demonstrate high fibrin affinity for targeted clot binding.
  • Anistreplase offers a longer half-life for convenient administration; alteplase requires heparin adjunctive therapy.

Conclusions:

  • Pharmacologic differences among thrombolytic agents are clinically significant for AMI treatment.
  • The theoretical advantages of these agents are beginning to be applied in clinical practice.
  • Understanding these distinctions is crucial for optimizing patient care in acute myocardial infarction.

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