Adjunctive medications in patients receiving thrombolytic therapy: a multicenter prospective assessment. The Virginia Multicenter Thrombolytic Study Group.
OBJECTIVE
To describe the use of adjunctive therapies in patients with acute myocardial infarction receiving thrombolytic agents.


METHODS
Data were collected prospectively by the study-site investigator or the emergency department physician caring for the patient. Study participation did not influence thrombolytic regimen selection or the adjunctive therapies ordered.


METHODS
Thirteen Virginia hospitals representing a cross-section of hospitals in the state. Eleven are urban medical centers; four have graduate medical education programs.


METHODS
Patients were included in the study if the decision to administer thrombolytic therapy was made in the emergency department.


METHODS
Concomitant medications administered during the first six hours after initiation of thrombolytic therapy.


RESULTS
Two hundred ten patients (aged 57 +/- 14.1 y) were evaluated. Ninety-five percent of these patients were treated with tissue plasminogen activator, 3 percent received anisoylated plasminogen streptokinase activator complex, and 2 percent received streptokinase. Ninety-one percent of the patients also received heparin, the most commonly used adjunctive medication; 77 percent concomitantly received lidocaine; 62 percent received aspirin; and only 19 percent received a beta-blocker.


CONCLUSIONS
Our data provide a reference point for future studies to determine factors that influence the selection of adjunctive agents for treating patients with acute myocardial infarction receiving thrombolytics.
Department of Pharmacy and Pharmaceutics, School of Pharmacy, Virginia Commonwealth University, Richmond.
E R
ER
Gonzalez
L A
LA
Jones
J P
JP
Ornato
G C
GC
Bleecker
M J
MJ
Strauss
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D001241:Aspirin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D011446:Prospective Studies; D013300:Streptokinase / Q000627:therapeutic use; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D005343:Fibrinolytic Agents; D006493:Heparin; D008012:Lidocaine; D013300:Streptokinase; D010959:Tissue Plasminogen Activator; D001241:Aspirin