Why the study?
Does prolonged infusion of t-PA reduce intracoronary thrombi and in-hospital cardiac events in patients with unstable angina?
Does prolonged infusion of t-PA reduce intracoronary thrombi and in-hospital cardiac events in patients with unstable angina?
In patients with unstable angina, prolonged t-PA infusion reduces intracoronary thrombi but does not improve clinical outcomes and may paradoxically worsen myocardial perfusion.
Caution against prolonged t-PA in unstable angina; challenges thrombus reduction as a reliable surrogate for clinical benefit.
We conclude that a prolonged infusion of t-PA in unstable angina reduces intracoronary thrombi but does not significantly decrease in-hospital cardiac events. The sample size, however, does not provide sufficient power to rule out a treatment effect. Paradoxically, there appears to be an increase in ST shift and worsening of myocardial perfusion with t-PA compared with therapy with heparin alone.
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Freeman et al. (1992) studied this question.
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