- Acute ST-segment elevation myocardial infarction: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). [Practice Guideline]
- This chapter about fibrinolytic, antiplatelet, and antithrombin treatment for acute ST-segment elevation (STE) myocardial infarction (MI) is part of the American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Grade 1 recommendations are strong and indicate that the benefits do, or do not, outweigh risks, burden, and costs. Grade 2 suggests that individual p…
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- Thrombolysis and adjunctive therapy in acute myocardial infarction: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. [Practice Guideline]
- This chapter about antithrombotic therapy for acute myocardial infarction (MI) is part of the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy: Evidence Based Guidelines. Grade 1 recommendations are strong and indicate that the benefits do, or do not, outweigh risks, burden, and costs. Grade 2 suggests that individual patients' values may lead to different choices (for a full un…
- A review of the long term effects of thrombolytic agents. [Review]
- Unequivocal evidence exists that reperfusion therapy, when given within 12 hours after onset of symptoms, saves the lives of patients with acute myocardial infarction (MI). As a result, the routine use of such treatment has increased rapidly since the mid-1980s but the rates of utilisation have been relatively static over the last decade at approximately 50% of patients with acute MI. The major q…
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- Supervision of thrombolysis of acute myocardial infarction using telemedicine. [Journal Article]
- The treatment of acute myocardial infarction (MI) constitutes a significant problem in remote geographical areas of Greece. Furthermore, thrombolysis, the treatment of choice in the early phase of acute MI, requires the supervision of an expert. We have used thrombolytic treatment, using telemedicine, in remote medical centres. The Onassis Cardiac Surgery Centre was linked to six remote Aegean is…
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- The magnitude of the benefit from preCCU thrombolysis in acute myocardial infarction: a long term follow up. [Randomized Controlled Trial]
- CONCLUSIONS: The magnitude of the benefit from earlier thrombolysis is such that giving thrombolytic treatment earlier is the main problem to reduce the time from onset of symptoms to reperfusion, to salvage myocardial muscle and obtain diverging survival curves.
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- Multivariate associates of QT dispersion in patients with acute myocardial infarction: primacy of patency status of the infarct-related artery. TEAM-3 Investigators. Third trial of Thrombolysis with Eminase in Acute Myocardial Infarction. [Journal Article]
- CONCLUSIONS: Successful thrombolysis is associated with less QTd in patients after acute MI. Our results support the hypothesis that QTd after MI depends on reperfusion status, reinfarction, and left ventricular function. Reduction in QTd may be an additional mechanism by which the benefit of thrombolytic therapy is realized.
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- Does the potential for development of streptokinase antibodies change the risk-benefit ratio in older patients? [Review]
- In patients with acute myocardial infarction (MI), quick initiation of thrombolytic therapy is the best strategy for improvement of survival and reduction of morbidity. Streptokinase, a purified product of haemolytic streptococci, is the most commonly administered agent. The compound anistreplase (a complex of streptokinase to plasminogen), is available but currently not often used. The non-antig…
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- [The effect of thrombolytic therapy with the preparation APSAC on the course of myocardial infarct]. [Clinical Trial]Ter Arkh. 1994; 66(9):41-5.TA
- To evaluate the influence of thrombolytic therapy (TT) on the course of acute myocardial infarction (AMI), a comparative analysis of clinical and pathological findings was conducted. The latter included post mortem examination of 35 myocardial samples from patients treated with APSAC in the acute phase of the infarction. The analysis indicated the predominance of cases with unfavourable coronary …
- Thrombolysis: state of the art. [Review]
- Thrombolytic treatment and aspirin will save about 50 in 1000 patients treated for acute myocardial infarction, but with a risk of cerebral or other serious bleeding in two to three in every 1000. Early treatment (< 4 h) about halves mortality; the benefits decline with time but are clearly proven up to 12 h from onset. Benefit is best and risk least when there is ST elevation and bundle branch (…
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- What you should know about thrombolytic therapy for acute MI. [Case Reports]Am J Nurs. 1993 Sep; 93(9):24-31; quiz 33.AJ
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- Intravenous thrombolytic therapy in myocardial infarction: an analytical review. [Review]Clin Cardiol. 1993 Apr; 16(4):283-92.CC
- The properties and physiological effects of three currently FDA-approved thrombolytic agents, streptokinase (SK), tissue plasminogen activator (tPA), and anisoylated plasminogen 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…
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- Short- and long-term comparative study of anistreplase versus streptokinase in acute myocardial infarction. [Randomized Controlled Trial]Angiology. 1992 Jul; 43(7):572-7.A
- Streptokinase is well established as an effective thrombolytic. Anistreplase, a new thrombolytic drug, is a complex of streptokinase and acylated human plasminogen that can be administered by intravenous bolus and activates plasminogen at the clot site. Although both streptokinase and anistreplase are effected in treating myocardial infarction (MI), they have different pharmacologic properties. T…
- Serum myoglobin and creatine kinase enzymes in acute myocardial infarction treated with Anistreplase. [Randomized Controlled Trial]
- CONCLUSIONS: Although TTP myoglobin results were significantly lower in the R group, TTP myoglobin will probably not be useful as an non-invasive indicator of reperfusion because of the overlap in values between the two groups. The significant reduction in the AUC and epsilon ST only in the R group suggests decreased infarct size. However, in this small preliminary study reperfusion did not occur more frequently with Anistreplase than without.
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- "Brain attack": an indication for thrombolysis? [Review]
- CONCLUSIONS: Pharmacists need to be knowledgeable of new treatments of stroke and the risks associated with them. As patient educators, pharmacists can contribute to public awareness by promoting the early recognition of stroke symptoms. As pharmacotherapists, pharmacists need to understand the risks and the important monitoring parameters related to thrombolysis. The results of ongoing multicenter clinical trials are awaited before making a final judgment on the usefulness of thrombolysis in acute ischemic stroke.
- Thrombolytic therapy in acute MI. Weighing the risks and benefits. [Review]
- The underlying cause of acute myocardial infarction can now be effectively treated with thrombolytic agents, thereby increasing myocardial salvage and reducing mortality. Clinicians should always be aware of the risk-to-benefit ratio in treating patients with thrombolytic agents and treat each patient on an individual basis.
- Anistreplase for acute M.I. [Journal Article]Nursing. 1990 Oct; 20(10):113.N
- Thrombolytic therapy in acute myocardial infarction. [Review]
- Recombinant tissue-type plasminogen activator (rt-PA), streptokinase (SK), and anisoylated plasminogen-streptokinase activator complex (APSAC) have salutary effects on mortality when administered to patients with evolving acute myocardial infarction (MI). Studies suggest that intravenous rt-PA is more effective in reperfusing occluded infarct-related arteries than SK, and the results of ongoing s…
- Interventions in acute myocardial infarction. [Review]Circulation. 1990 Mar; 81(3 Suppl):IV43-50.Circ
- Results of multiple studies have amply verified the benefit of urgent coronary revascularization for patients who have acute myocardial infarction (MI). Currently, intravenous thrombolytic therapy is the treatment of choice for many patients, especially those 75 years old or younger who present within 6 hours of symptom onset and who are without contraindications to thrombolytic therapy. Some pat…
- Improved left ventricular function in myocardial infarction following intravenous thrombolytic therapy with acylated plasminogen activator. [Journal Article]
- Forty-six patients with acute myocardial infarction (MI) were treated within three hours of the onset of chest pain with an intravenous bolus (IV) of 30 units of anisolated plasminogen activator streptokinase complex (APSAC). Reperfusion was detected in 31 patients (67%) by clinical, electrocardiographic, and enzymatic criteria. The mean time elapsed between the onset of the chest pain to thrombo…
- Limitation of myocardial infarct size and preservation of left ventricular function by early administration of APSAC in myocardial infarction. [Randomized Controlled Trial]Am J Cardiol. 1989 Jul 05; 64(2):18A-23A; discussion 24A-26A.AJ
- In cases of acute myocardial infarction (MI), it has been shown that preserving left ventricular function and limiting infarct size with early reperfusion of the occluded artery by means of a thrombolytic agent could eventually result in a reduced mortality rate. The aim of the APSIM study (anisoylated plasminogen streptokinase activator complex [APSAC] dans l'infarctus du Myocarde) was to demons…
- Reperfusion, patency and reocclusion with anistreplase (APSAC) in acute myocardial infarction. [Review]
- Because the reestablishment of coronary blood flow is believed to be central to the benefit of thrombolytic therapy, measurements of reperfusion (i.e., angiography before and after therapy), patency (i.e., angiography after therapy) and reocclusion rates are important to the evaluation of new thrombolytic therapies. For anisoylated plasminogen streptokinase activator complex (APSAC, anistreplase)…
- Body surface potential mapping to monitor the effects of thrombolytic therapy following acute myocardial infarction. [Case Reports]J Electrocardiol. 1989; 22 Suppl:82-90.JE
- The authors demonstrate the value of body surface potential mapping (BSPM) and a limited lead system in monitoring complete ECG evolution following myocardial infarction (MI) and the effects of thrombolytic therapy. They produced ST-segment isopotential maps, which indicate the site and extent of myocardial injury. Pathological Q wave maps were also produced, which intimate the extent of myocardi…