A comparison between heparin and low-dose aspirin as adjunctive therapy with tissue plasminogen activator for acute myocardial infarction
Article Abstract:
It is now well established that thrombolytic treatment within the first few hours after a heart attack can improve heart function and reduce mortality. Thrombolytic agents, such as streptokinase and recombinant tissue plasminogen activator (rt-PA), help dissolve the blood clots that block coronary arteries (which supply the heart muscle with blood) and cause heart attack. While the effectiveness of these agents has been repeatedly confirmed, the treatment protocols that will provide the maximum possible benefit to the patient remain to be determined. For this reason, a study was conducted to assess the efficacy of adjunctive treatment with heparin or aspirin, two antithrombic substances (which suppress blood clotting). A total of 205 patients received rt-PA within six hours of a heart attack; 106 were placed on intravenous heparin and the remaining 99 patients received 80 milligrams of aspirin per day. In addition to tabulating the heart attack complications of the two groups, researchers also evaluated the coronary arteries by angiography (an X-ray technique) to objectively determine blockage and blood flow within the arteries. The results demonstrate that the arteries of the patients treated with heparin were providing better blood flow to the heart muscle. Among the patients treated with heparin, 82 percent of the arteries related to the heart attack were patent, or open, at the time of the first angiogram, in contrast with only 52 percent of the arteries in the aspirin-treated group. While hemorrhage is a potential complication of treatment with antithrombic drugs, there were no significant differences in the hemorrhagic complications between the two groups. A blood clot, or thrombus, occluding a coronary artery is a dynamic entity, and clotting processes may be proceeding even as a thrombolytic enzyme dissolves the clot. Heparin apparently provided significant benefit to the heart attack patients by interfering with reocclusion of coronary arteries that had been opened by tissue plasminogen activator. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1990
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A comparison of reteplase with alteplase for acute myocardial infarction
Article Abstract:
Two related drugs, alteplase and reteplase, appear to be equally safe treatments for patients with recent heart attacks. These drugs are used to break up blood clots that cause most heart attacks. Death and stroke rates were compared in 15,059 patients given either alteplase or reteplase within six hours of a heart attack. Of the patients given reteplase, 7.47% died within 30 days of the heart attack and 1.64% had a stroke. Of the patients given alteplase, 7.24% died within 30 days of the heart attack and 1.79% had a stroke.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1997
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- Abstracts: Comparison of invasive and conservative strategies after treatment with intravenous tissue plasminogen activator in acute myocardial infarction; results of the Thrombolysis in Myocardial Infarction (TIMI) Phase II Trial
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