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November 2, 1999Circulation

Double bolus (10+10 U) reteplase and streptokinase resulted in lower platelet aggregation at 1 and 2 hours than therapy with accelerated alteplase.

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Why the study?

Do different thrombolytic agents (reteplase, streptokinase, alteplase) differentially affect early platelet aggregation and activation in patients with acute myocardial infarction?

Population

126 patients with acute myocardial infarction enrolled in a single center from the RAPID-1, RAPID-2, INJECT…

Comparison

Reteplase or streptokinase vs Alteplase

Design

Cohort

Follow-up

2 hours

Authors

MMMartin MoserTNThomas K. NordtKPKarlheinz Peter

Discussion

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Overview

May inform thrombolytic selection in AMI; leaves open effects on reperfusion or outcomes.

Structured PICO

Do different thrombolytic agents (reteplase, streptokinase, alteplase) differentially affect early platelet aggregation and activation in patients with acute myocardial infarction?

P
Population
126 patients with acute myocardial infarction enrolled in a single center from the RAPID-1, RAPID-2, INJECT, and GUSTO-3 trials
I
Intervention
Reteplase (10+10-U double bolus [n=50], 10+5-U double bolus [n=15], or 15-U single bolus [n=15]) or streptokinase (1.5 MU/60 min [n=10])
C
Comparator
Alteplase (conventional 100 mg/180 min [n=15] or accelerated 100 mg/90 min [n=21])
O
Outcome
Platelet aggregation (PA) after stimulation with ADP, P-selectin expression, and fibrinogen binding to glycoprotein (GP) IIb/IIIa at 1 and 2 hourssurrogate

Reteplase and streptokinase induce a more pronounced early decrease in platelet aggregation compared to accelerated alteplase during thrombolytic therapy for acute myocardial infarction.

Cite This Study

Moser et al. (1999) studied this question.

synapsesocial.com/papers/6a880d04a95381ace1bbf623https://doi.org/10.1161/01.cir.100.18.1858
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