February 1, 1989Circulation
A randomized controlled trial of intravenous tissue plasminogen activator and early intravenous heparin in acute myocardial infarction.
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Discussion
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Implication
Randomized trial evaluates the effect of heparin on thrombolysis in myocardial infarction, suggesting no improvement.
Key Points
- This trial aims to evaluate whether early intravenous heparin improves the thrombolytic effect of tissue plasminogen activator in patients with acute myocardial infarction.
- 134 patients were randomly assigned to receive t-PA alone or in combination with early heparin.
- Coronary angiography was performed 90 minutes after therapy to assess infarct vessel patency.
- Fibrinogen levels and bleeding complications were also measured.
- Infarct vessel patency was 79% for both combination treatment and t-PA alone.
- Bleeding complications were similar between groups: 13% for t-PA and heparin vs 18% for t-PA only (p=0.53).
- Fibrinogen decreased 32% in the combination group compared to a 39% decrease in the control group.
Cite This Study
Topol et al. (1989) studied this question.