Open AccessIntravenous thrombolytic therapy in myocardial infarction: An analytical review
Author(s) -
Shammas Nicolas W.,
Fitzpatrick Patricia,
Zeitler Rodney
Publication year - 1993
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960160402
Subject(s) - medicine , streptokinase , myocardial infarction , tissue plasminogen activator , ejection fraction , cardiology , fibrinolytic agent , infarction , intensive care medicine , heart failure
The properties and physiological effects of three currently FDA‐approved thrombolytic agents, streptokinase (SK), tissue plasminogen activator (tPA), and anisoylated plasmminogen activator complex (APSAC) are reviewed. All thrombolytic agents have been shown to reduce mortality postmyocardial infarction (MI). Comparative trials have failed to demonstrate a difference between the effects of tPA, SK, and APSAC on mortality. In addition, no consistent difference between the three agents on ejection fraction (EF) has been found despite a superior reperfusion rate with tPA at 90 min. Further‐more, reinfarction and interventional procedure rates were significantly higher after thrombolytic treatment, and the incidence of total strokes was higher with tPA than SK in some comparative studies. Based on analysis of the published megatrials, SK is a more cost‐effective thrombolytic agent for patients with acute MI than tPA or APSAC.