title: Effect of the initial bolus volume of recombinant tissue-type plasminogen activator on coronary recanalization and infarct size in Japanese acute myocardial infarction patients. Kumamoto University Myocardial Infarction Study (KUMIS) Group.
abstract: Coronary recanalization rate and infarct size were compared between 2 different methods of intravenously administering recombinant tissue-type plasminogen activator (rt-PA) 41.4 mg; 1) an initial bolus dose of 30% followed by infusion of the remainder over 60 min (30% group), and an initial bolus dose of 10% followed by infusion of the remainder over 60 min (10% group). Thirty min after beginning rt-PA infusion, the coronary recanalization rate was higher in the 30% group than in the 10% group (82.9% (34/41) vs 53.7% (22/41), p < 0.01). The peak creatine kinase and peak creatine kinase-MB levels were lower in the 30% group than in the 10% group. We conclude that a higher initial bolus dose of rt-PA gives a higher rate of recanalization of the infarct-related artery at the very early phase, and probably leads to a smaller infarct size.
authors.affiliation: Division of Cardiology, Kumamoto University School of Medicine, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Ogawa
authors.forename: H
authors.initials: H
authors.lastname: Yasue
authors.forename: S
authors.initials: S
authors.lastname: Oshima
authors.forename: Y
authors.initials: Y
authors.lastname: Ogata
authors.forename: Y
authors.initials: Y
authors.lastname: Numata
authors.forename: K
authors.initials: K
authors.lastname: Fujimoto
authors.forename: N
authors.initials: N
authors.lastname: Imoto
authors.forename: T
authors.initials: T
authors.lastname: Saito
authors.forename: Y
authors.initials: Y
authors.lastname: Hokamura
authors.forename: T
authors.initials: T
authors.lastname: Takahashi
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D003402:Creatine Kinase / Q000097:blood; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous / Q000379:methods; D007527:Isoenzymes; D007564:Japan; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000201:enzymology / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D015425:Myocardial Reperfusion / Q000379:methods*; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D012008:Recurrence; D012307:Risk Factors; D012720:Severity of Illness Index; D013318:Stroke Volume; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage* / Q000627:therapeutic use
chemical_list: D007527:Isoenzymes; D011994:Recombinant Proteins; D003402:Creatine Kinase; D010959:Tissue Plasminogen Activator