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New developments in thrombolytic therapy.

D C Collen1, H K Gold

  • 1Center for Thrombosis and Vascular Research, University of Leuven, Belgium.

Thrombosis Research. Supplement
|January 1, 1990
PubMed
Summary
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Thrombolytic agents like streptokinase and recombinant tissue-type plasminogen activator (rt-PA) treat cardiovascular disease by dissolving blood clots. While rt-PA is more effective, both have similar side effects, and further trials are needed to confirm mortality benefits.

Area of Science:

  • Cardiovascular Medicine
  • Hematology
  • Pharmacology

Background:

  • Thrombotic cardiovascular diseases are a leading cause of death and disability.
  • Thrombolytic agents activate plasminogen to plasmin, dissolving fibrin clots.
  • Plasmin can degrade hemostatic components, increasing bleeding risk.

Purpose of the Study:

  • To review current thrombolytic agents for acute myocardial infarction.
  • To compare the efficacy and safety of different thrombolytic therapies.
  • To assess the potential role of thrombolysis in routine cardiovascular care.

Main Methods:

  • Review of clinical studies on thrombolytic agents.
  • Comparison of efficacy, fibrin-specificity, and side effect profiles.
  • Analysis of cost-effectiveness and clinical outcomes.

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Main Results:

  • Recombinant tissue-type plasminogen activator (rt-PA) is more effective and fibrin-specific than streptokinase.
  • Streptokinase recanalizes 40-45% of coronary arteries, reducing mortality by 25%.
  • rt-PA achieves 65-70% reperfusion but at a higher cost; side effects are similar.

Conclusions:

  • Thrombolytic therapy is likely to become routine for acute myocardial infarction.
  • rt-PA offers higher efficacy, but cost-effectiveness and mortality benefits require further study.
  • Both streptokinase and rt-PA are available for clinical use.