title: Effects of intravenous administration of tissue plasminogen activator before thrombectomy in patients with acute myocardial infarction.
abstract: BACKGROUND
  Myocardial salvage after acute myocardial infarction (AMI) largely depends on the removal of infarct-related thrombus. Although both thrombolysis and thrombectomy are effective strategies to remove thrombus, there is a paucity of reports regarding the benefit of the combination therapy. Therefore, the efficacy of intravenous administration with mutant tissue plasminogen activator (Mt-PA) before thrombectomy and ordinary percutaneous coronary intervention (PCI) was evaluated.
  
  
  RESULTS
  Consecutive 44 AMI patients without contraindication of Mt-PA were enrolled in the study and randomly assigned to thrombectomy with Mt-PA pre-administration (group T) or thrombectomy alone (group N). Although Thrombolysis in Myocardial Infarction (TIMI) grade before PCI and TIMI myocardial perfusion grade immediately after PCI were significantly greater in group T (p<0.05), there was no improvement of left ventricular ejection fraction immediately and 6 months after PCI.
  
  
  CONCLUSIONS
  These results suggest that intravenous administration with Mt-PA before thrombectomy had no significant benefit in the salvage of infracted myocardium over thrombectomy alone, despite improvement of coronary microcirculation immediately after PCI.
authors.affiliation: The Cardiovascular Center, Kansai Medical University, Japan. yamamosa@hirakata.kmu.ac.jp
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kamihata
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Sutani
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Akita
authors.forename: Hajime
authors.initials: H
authors.lastname: Otani
authors.forename: Toshiji
authors.initials: T
authors.lastname: Iwasaka
mesh_terms: D000208:Acute Disease; D000368:Aged; D000792:Angiography; D015906:Angioplasty, Balloon, Coronary; D003131:Combined Modality Therapy; D003326:Coronary Circulation / Q000187:drug effects / Q000502:physiology; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery*; D017131:Thrombectomy; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D016277:Ventricular Function, Left / Q000187:drug effects / Q000502:physiology
chemical_list: D003402:Creatine Kinase; D010959:Tissue Plasminogen Activator