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Titolo:
Alteplase: descendancy in myocardial infarction, ascendancy in stroke
Autore:
Doggrell, SA;
Indirizzi:
Doggrell Biomed Commun, Auckland, New Zealand Doggrell Biomed Commun Auckland New Zealand mmun, Auckland, New Zealand
Titolo Testata:
EXPERT OPINION ON INVESTIGATIONAL DRUGS
fascicolo: 11, volume: 10, anno: 2001,
pagine: 2013 - 2029
SICI:
1354-3784(200111)10:11<2013:ADIMIA>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
TISSUE-PLASMINOGEN-ACTIVATOR; ACUTE ISCHEMIC STROKE; MASSIVE PULMONARY-EMBOLISM; RANDOMIZED CONTROLLED TRIAL; PERIPHERAL ARTERIAL OCCLUSIONS; THROMBOLYTIC EFFICACY LATE; DEEP VENOUS THROMBOSIS; PRIMARY ANGIOPLASTY; RT-PA; DOUBLE-BLIND;
Keywords:
alteplase; myocardial infarction; peripheral vascular disease; stroke; thromboembolism;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
91
Recensione:
Indirizzi per estratti:
Indirizzo: Doggrell, SA Univ Queensland, Dept Physiol & Pharmacol, Brisbane, Qld 4072, Australia Univ Queensland Brisbane Qld Australia 4072 4072, Australia
Citazione:
S.A. Doggrell, "Alteplase: descendancy in myocardial infarction, ascendancy in stroke", EXPERT OP I, 10(11), 2001, pp. 2013-2029

Abstract

Tissue type plasminogen activator is available, through recombinant technology, for thrombolytic use as alteplase. Alteplase is relatively clot specific and should cause less bleeding side effects than the non-specific agents such as streptokinase. Alteplase has been used successfully in evolving myocardial infarction (MI) to reopen occluded coronary arteries. It is probably equally effective or superior to streptokinase in opening arteries and reducing mortality in Mi. Alteplase is most effective when given early in Mi and is probably ineffective when given 12 h after the onset of symptoms. The effectiveness of alteplase in Mi can be increased by front loading witha bolus of 15 mg, followed by an infusion of 50 mg over 30 min and 35 mg over 60 min. Percutaneous transluminal coronary angioplasty or stenting is associated with a greater patency and lower rates of serious bleeding, recurrent ischaemia and death than alteplase in MI and is likely to take over from alteplase as the standard Mi treatment. A reduced dose of alteplase to increase coronary artery patency prior to angioplasty may be useful in Mi. An exciting new indication for the use of alteplase is in stroke, where it has become the first beneficial intervention. Alteplase is used to reopen occluded cerebral vessels but is associated with an increased risk of intracerebral haemorrhage. Alteplase is beneficial if given within 3 h of the onset of stroke but not after this time period. Therefore, the next challenge is to increase the percentage of people being diagnosed and treated within this period. Clinical trials have not established a role for alteplase in the treatment of acute coronary syndromes or deep vein thrombosis. However, alteplase is useful in treating pulmonary thromboembolism and peripheral vascular disease.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 21/01/20 alle ore 06:52:40