Open AccessFibrinolysis With TPA Alone Is Only One Third As Effective As It Should Be
Author(s) -
Victor Gurewich
Publication year - 2020
Publication title -
hsoa journal of angiology and vascular surgery
Language(s) - English
Resource type - Journals
ISSN - 2572-7397
DOI - 10.24966/avs-7397/100049
Subject(s) - fibrinolysis , streptokinase , tissue plasminogen activator , myocardial infarction , medicine , fibrin , fibrinolytic agent , plasminogen activator , cardiology , fibrinolytic therapy , immunology
Therapeutic fibrinolysis has used tissue Plasminogen Activator (tPA) alone since 1987,when tPA was first approved for the treatment of Acute Myocardial Infarction (AMI). The use of Tpa was based on the belief that it was responsible for fibrinolysis. However, this assumption should have been put into question from the outset when tPA was found to have the same efficacy as Streptokinase (SK). This was unexpected, since SK has an indirect, less efficient mechanism of action and SK has no fibrin clot affinity, in contrast to tPA. Nevertheless, the 30-day AMI mortality with tPA and SK were identical in the first two trials.