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[Fibrinolytic agents--who benefits when?]
1Institut für Transfusionsmedizin und Immunhämatologie, Blutspendedienst Hessen des DRK, Frankfurt.
Therapeutische Umschau. Revue Therapeutique
|October 1, 1995
Summary
Thrombolytic therapy enhances the body's natural clot-dissolving process using various agents. It is a proven treatment for heart attacks, pulmonary embolism, and deep vein thrombosis, with promising results for stroke.
Area of Science:
- Pharmacology
- Cardiovascular Medicine
- Hematology
Background:
- Thrombolytic therapy aims to enhance physiological fibrinolysis for treating thromboembolic diseases.
- Available agents include non-physiological streptokinase, APSAC, and physiological urokinase and tissue plasminogen activator (t-PA).
Purpose of the Study:
- To review the clinical applications and efficacy of various thrombolytic agents.
- To highlight the established and emerging roles of thrombolytic therapy in cardiovascular and thromboembolic conditions.
Main Methods:
- Review of existing literature on thrombolytic agents and their clinical use.
- Comparison of different thrombolytics based on their mechanism of action and fibrin selectivity.
Main Results:
- Tissue plasminogen activator (t-PA) exhibits relative fibrin selectivity compared to other agents.
- Thrombolytic therapy is established for acute myocardial infarction and pulmonary embolism.
- It is superior to heparin for proximal deep venous thrombosis and effective for peripheral arterial occlusive disease.
- Promising initial results are reported for stroke treatment.
Conclusions:
- Thrombolytic therapy is a critical treatment modality for various thromboembolic events.
- Agent selection depends on the specific condition, with t-PA offering fibrin selectivity.
- Emerging applications, such as in stroke, show potential for expanded use.