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Updated: Jul 29, 2026

Prehospital Thrombolysis: A Manual from Berlin
Published on: November 27, 2013
Thrombolytic therapy in acute myocardial infarction--selected recent developments
Insights
New pharmacological agents are being developed to improve thrombolytic therapy for acute myocardial infarction. These include novel plasminogen activators and adjunctive anticoagulants and antiplatelet agents to enhance treatment outcomes.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Thrombolytic therapy is the standard treatment for acute myocardial infarction.
- Early restoration of coronary artery patency is crucial for reducing mortality.
Purpose of the Study:
- To review the development of new pharmacological agents for thrombolytic therapy.
- To discuss novel plasminogen activators and adjunctive therapies.
Main Methods:
- Review of clinical development and animal testing of new agents.
- Discussion of pharmacological mechanisms and potential applications.
Main Results:
- Several new plasminogen activators (reteplase, saruplase, staphylokinase, DSPA, antibody-targeted plasminogen activators) are in development.
- Promising adjunctive therapies include recombinant hirudin, hirulog, argatrobane, Factor Xa inhibitors, and antiplatelet agents.
Conclusions:
- Ongoing research aims to improve thrombolytic therapy efficacy.
- New agents hold promise for enhancing outcomes in acute myocardial infarction treatment.
Abstract:
Thrombolytic therapy is the established treatment of choice for most eligible patients with acute myocardial infarction. Early initiation of treatment and early, complete and maintained patency of the infarct-related coronary artery are desirable, because these variables correlate with a reduction in mortality. As a consequence, considerable efforts have been undertaken to develop new pharmacological agents that serve these purposes. Among these, new plasminogen activators such as reteplase (r-PA), saruplase (scuPA), and staphylokinase are in clinical development, and DSPA (bat t-PA) and antibody-targeted plasminogen activators (ScuPA-59D8) have undergone extensive animal testing. Anticoagulants such as recombinant hirudin, hirulog, argatrobane, and Factor Xa inhibitors, as well as antiplatelet agents on the basis of monoclonal antibody 7E3 offer promise as adjunctive therapy to thrombolysis or to invasive intracoronary procedures.
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