Facilitated thrombolysis: dethrombosis?
Intracoronary thrombus formation results from the combined effects of platelet aggregation and fibrin formation. Fibrinogen plays a significant role in each of these components. Dethrombosis is a therapeutic approach that allows dissolution of a recent thrombus while avoiding the potent fibrinolytic therapies. The less aggressive strategies suggested to achieve dethrombosis are antifibrin, antiplatelet, and defibrinogenation. Glycoprotein receptor antagonists have been beneficial in patients undergoing percutaneous transluminal coronary angioplasty; however, little is known about their potency of inducing reperfusion in acute myocardial infarction. Early use of the strategies suggested to induce dethrombosis (antifibrin, antiplatelet, and defibrinogenation) may facilitate fibrinolysis and primary angioplasty and further induce reperfusion. Nevertheless, the theoretical arguments of facilitated thrombolysis (dethrombosis) have not yet been fruitful as a major clinical benefit except in patients undergoing primary percutaneous coronary intervention.
Luciardi
Héctor
H
Curso Superior de Médico Cardiólogo and Magíster on Thrombosis, Facultad de Medicina, Universidad Nacional de Tucumán, Argentina. hectorlucas@sinectis.com.ar
Berman
Sofía
S
Muntaner
Juan
J
de la Serna
Fernando
F
Altman
Raúl
R
D005342:Fibrinolysis; D006401:Hematologic Agents / Q000627:therapeutic use; D006801:Humans; D015424:Reperfusion / Q000379:methods; D015912:Thrombolytic Therapy / Q000379:methods*; D013927:Thrombosis / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control
D006401:Hematologic Agents