Avtor/Urednik		Noč, Marko; Remškar, Mojca; Horvat, Matija
Naslov		Thrombolysis for acute myocardial infarction
Tip		članek
Vir		In: Pajer Z, Štiblar-Martinčič D, editors. International symposium on cardiovascular diseases. Proceedings of the 29th memorial meeting devoted to prof. dr. Janez Plečnik; 1998 Dec 3-5; Ljubljana. Ljubljana: Medical faculty, Institute of histology and embryology,
Leto izdaje		1998
Obseg		str. 207-11
Jezik		eng
Abstrakt		In the past 20 years, pathological and arteriographic studies have shown that Q-wave myocardial infarctionis caused by an occlusive thrombus in a coronary artey. The primary therapeutic objective is the prompt restoration of anterograde flow in the occluded artery. Thrombolytic therapy has been a major advance in the management of acute myocardial infarction. it works by lysing infarct artery thrombi and achieving reperfusion, thereby reducing infarct size, preserving left ventricular function, and improving survival. Thrombolysis is administered as soon as possible in patients without contraindication who present within 12 hours of symptom onset and have ST-segment elevation on the electrocardiogram or new-onset bundle-branch block. Streptokinase and tissue plasminogen activator (t-PA) together with adjunctive aspirin and heparin are currently the preferred thrombolytic regimens. However, even the most effective thrombolytic regimen with t-PA achieves complete angiographic epicardial infarct-artery patency in only 50% within 90 minutes. Bleeding requiring transfusion occurs inapproximately 5% and stroke in 1.8%. Ne thrombolytic strategies are therefore being developed to improve the efficacy of clot lysis, ease of administration and reduce bleeding complications. These strategies include different dosing regimens of established agents,combination of different agents, improved adjuctive therapy such as direct antithrombin agents, low molecular-weight heparin or glycoprotein llb/llla receptor antagonists or the development of novel thrombolytic agents. These agents such as reteplase, TNK-tPA, lanoteplase, staphylokinase and saruplase are aimed to have enhanced fibrin specificity, resistance to native inhibitors and prolonged halflives allowing bolus administration. All of these strategies are currently being tested in clinical trials.
Deskriptorji		MYOCARDIAL INFARCTION THROMBOLYTIC THERAPY ACUTE DISEASE