Thrombolytic therapy for unstable angina pectoris: rationale and results

The coronary lesion in unstable angina consists of disrupted atherosclerotic plaque with nonocclusive intraluminal thrombus, which frequently persists despite heparin anticoagulation. A 12 hour infusion of recombinant tissue-type plasminogen activator combined with heparin effectively lyses the thrombus and stabilizes the clinical syndrome but is associated with a high incidence of bleeding. Therapeutic schemes of thrombolytic therapy associated with a lower bleeding frequency may be useful for the treatment of unstable angina.