[New substances and dosages for thrombolysis in acute myocardial infarct].
The aim of thrombolytic therapy in acute myocardial infarction is the early, complete and sustained restoration of bloodflow in the infarct-related artery. In a randomized trial in 421 patients with acute myocardial infarction front-loaded rt-PA (100 mg in 90 min) showed a significantly higher 90-min patency (84.4%) in comparison with APSAC (70.3%). In-hospital mortality was significantly lower after rt-PA (2.4%) versus 8.1% after APSAC. While a single bolus injection of rt-PA produced lower patency and higher reocclusion rates, double bolus injections showed more promising results (90 min patency > 70%). A new recombinant plasminogen activator BM 06.022 (r-PA) with a longer half life can be given as a single bolus injection. In a dose-finding study r-PA produced rapid thrombolysis with a 90-min patency of 66% (10 MU) and 76% (15 MU). There was no excess in re-occlusions or bleeding complications. Although these results are quite promising, the search for the ideal thrombolytic strategy is still ongoing.
Zeymer
U
U
Medizinische Klinik II, Städtische Kliniken Kassel.
Neuhaus
K L
KL
D003326:Coronary Circulation / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D009203:Myocardial Infarction / Q000097:blood / Q000188:drug therapy*; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000009:adverse effects
D005343:Fibrinolytic Agents; D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator
Neue Substanzen und Dosierungen für die Thrombolyse beim akuten Herzinfarkt.