Thrombolytic therapy in acute myocardial infarction--selected recent developments.
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.
Bode
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Medizinische Klinik III, Universität Heidelberg, Germany.
Nordt
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Runge
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D004792:Enzyme Precursors / Q000627:therapeutic use; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008666:Metalloendopeptidases / Q000627:therapeutic use*; D009203:Myocardial Infarction / Q000188:drug therapy*; D010960:Plasminogen Activators / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000627:therapeutic use; D015912:Thrombolytic Therapy / Q000639:trends*; D010959:Tissue Plasminogen Activator; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use*
D004792:Enzyme Precursors; D005343:Fibrinolytic Agents; D011994:Recombinant Proteins; C087896:reteplase; D010960:Plasminogen Activators; D010959:Tissue Plasminogen Activator; D014568:Urokinase-Type Plasminogen Activator; D008666:Metalloendopeptidases; C022653:auR protein, Staphylococcus aureus; C067551:saruplase