Effects of intravenous administration of tissue plasminogen activator before thrombectomy in patients with acute myocardial infarction.
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.
Yamamoto
Satoshi
S
The Cardiovascular Center, Kansai Medical University, Japan. yamamosa@hirakata.kmu.ac.jp
Kamihata
Hiroshi
H
Sutani
Yasuo
Y
Akita
Yuzo
Y
Otani
Hajime
H
Iwasaka
Toshiji
T
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
D003402:Creatine Kinase; D010959:Tissue Plasminogen Activator