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EFFECTS OF HUMAN TISSUE-TYPE PLASMINOGEN ACTIVATOR ON CORONARY THROMBOLYSIS.
Because angiographic data indicate that small intracoronary thrombi can cause myocardial ischemia as well as infarction, Gold et al. randomized 24 patients with unstable angina to receive either placebo or intravenous recombinant tissue-type plasminogen activator (rT-PA). In this double-blind study, 6 of 11 patients on placebo had continued unstable angina, compared with only 1 of 12 patients who received rT-PA. Angiographic data were consistent with the hypothesis that clot lysis in the patients who received rT-PA led to the clinical improvements. Nonfatal bleeding complications led to premature termination of rT-PA in three of the 12 patients who received it.
This research supports the idea that intracoronary thrombi have a role in the development of unstable angina. More aggressive treatment with thrombolytic agents is likely to receive serious attention.
— THL
Published in Journal Watch General Medicine July 17, 1987
Citation(s):
Gold H K; Johns J A; Leinbach R C et al. A randomized, blinded, placebo-controlled trial of recombinant human tissue-type plasminogen activator in patients with unstable angina pectoris. Circulation 1987 Jun 75 1192-1199.
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