Why the study?
Do new thrombolytic strategies improve effective coronary reperfusion compared to currently available regimens?
Do new thrombolytic strategies improve effective coronary reperfusion compared to currently available regimens?
New thrombolytic strategies, including t-PA mutants and selective thrombin inhibitors, are being developed to improve the low rates of effective coronary reperfusion seen with current therapies.
Low TIMI 3 rates with current thrombolytics leave open whether t-PA mutants or thrombin inhibitors improve reperfusion; trials needed.
Recent angiographic studies after thrombolytic therapy have shown that the rates of effective coronary reperfusion (TIMI grade 3) is still quite low with currently available thrombolytic regimens. Approaches to improving thrombolytic efficacy include the development of mutants of t-PA, recombinant staphylokinase and conjugations of thrombolytic agents to monoclonal antibodies targeted to components of the thrombus. The development of more potent conjugative antithrombolysis therapy includes newer antiplatelet agents and selective thrombin inhibitors such as hirudin and Hirulog. Clinical trials of these new approaches are now underway and hold hope for improvement of reperfusion efficacy in coronary thrombolysis.
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Frans Van de Werf (1993) studied this question.
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