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Thrombolytic therapy.

D Collen1, D C Stump, H K Gold

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

Annual Review of Medicine
|January 1, 1988
PubMed
Summary
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Thrombolytic agents like streptokinase and tissue-type plasminogen activator (t-PA) dissolve blood clots. Newer agents aim for improved efficacy and reduced bleeding risks in treating conditions like myocardial infarction.

Area of Science:

  • Biochemistry
  • Pharmacology
  • Cardiology

Background:

  • Thrombolytic agents activate plasminogen to plasmin, dissolving fibrin clots.
  • First-generation agents (streptokinase, urokinase) have moderate efficacy and cause fibrinogen breakdown.
  • Early streptokinase reduced mortality in acute myocardial infarction.

Purpose of the Study:

  • To review thrombolytic agents for clot dissolution.
  • To compare the efficacy and specificity of different thrombolytic agents.
  • To explore emerging trends in thrombolytic therapy.

Main Methods:

  • Review of existing literature on thrombolytic agents.
  • Comparison of first-generation agents (streptokinase, urokinase) with newer agents (t-PA, scu-PA, Apsac).

Related Experiment Videos

  • Discussion of novel approaches including synergistic combinations, mutants, and targeted agents.

    • Main Results:

    • Streptokinase reduced in-hospital mortality in myocardial infarction.
    • Tissue-type plasminogen activator (t-PA) shows greater efficacy and fibrin specificity.
    • Single-chain urokinase-type plasminogen activator (scu-PA) is more fibrin-specific but in early investigation.

    Conclusions:

    • Thrombolytic therapy has evolved from less specific agents to more targeted approaches.
    • Tissue-type plasminogen activator (t-PA) offers improved fibrin specificity.
    • Future thrombolytic therapies focus on enhanced efficacy and reduced bleeding through novel agent development.