Anistreplase for acute coronary thrombosis

Article Abstract:

The drug anistreplase activates plasminogen, a blood protein that prevents the formation of blood clots, and was recently approved for treating coronary thrombosis, which is the formation of blood clots in the coronary arteries, the major blood vessels supplying the heart. Three other thrombolytic agents, urokinase, streptokinase, and alteplase, were previously approved for treating coronary thrombosis. Anistreplase, a complex of streptokinase and plasminogen, is broken down in the blood to an activator that converts plasminogen to plasmin, and thereby causes fibrinolysis, the breakdown of the clot. Anistreplase remains in the body for a longer period of time than alteplase, urokinase, and streptokinase. Several studies have demonstrated that anistreplase opens blocked coronary arteries and decreases the number of deaths among patients with myocardial infarction, or heart attack. Myocardial infarction is the deterioration of heart tissue due to the cessation of blood and oxygen supply. Anistreplase maintained an open coronary artery, improved the function of the left ventricle, and decreased the size of the infarcted tissue to a greater extent than another anticoagulant drug, heparin, in 231 patients with myocardial infarction. This new thrombolytic agent is similar to streptokinase with respect to effectiveness and adverse effects, but has not been compared with urokinase and alteplase. The adverse effects, conditions in which anistreplase should not be used, dosage and cost of the drug are discussed. In comparison with streptokinase, anistreplase is as effective and more convenient to use, but it is also more expensive. (Consumer Summary produced by Reliance Medical Information, Inc.)

Product/Service Evaluation, Drug therapy, Thrombosis, Plasminogen activators, Fibrinolytic agents, Thrombolytic drugs, Anistreplase, Eminase (Medication)

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Laser coronary angioplasty

Article Abstract:

Percutaneous transluminal coronary angioplasty (PTCA) is a procedure in which a balloon-tipped catheter is threaded into a coronary artery that is narrowed by fatty plaques (atherosclerosis). Inflation of the balloon reduces or removes the blockage, improving blood flow and decreasing signs of coronary artery disease such as angina (chest pain). PTCA has become accepted as an alternative to coronary artery bypass surgery, particularly when only one of the four coronary arteries is diseased. Complications of PTCA include arterial occlusion during the procedure, usually due to movement of the fatty plaque from the arterial wall into the arterial lumen (dissection), recurrence of disease (restenosis) after the procedure, and inability to treat arteries which are completely blocked. Lasers have now been used during PTCA to resolve some of these problems. Lasers may either be used directly, to vaporize the plaque, or as thermal agents for heating another probe which can burn away the plaque. Numerous reports suggest that laser angioplasty may be effective in some patients, although probe heating by the laser may have its own complications. No evidence for a decreased rate of restenosis has been found. Also, no controlled studies of benefits and side effects of PTCA with and without lasers have been done. Long-term effects of laser use within the coronary arteries are unknown. These preliminary reports indicate that laser angioplasty may be useful in some cases, but further research is needed to determine the extent of benefits and risks entailed by this procedure. (Consumer Summary produced by Reliance Medical Information, Inc.)

Innovations, Surgery, Transluminal angioplasty, Balloon angioplasty, Coronary arteries, Laser angioplasty

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Two new antiplatelet drugs for angioplasty and acute coronary syndromes

Article Abstract:

The FDA has approved two new drugs that prevent the formation of blood clots. Eptifibatide, which is sold under the name Integrilin, can be used in patients with unstable angina and heart attack. Tirofiban, whose trade name is Aggrastat, can be used in the same conditions. They both work by blocking the glycoprotein receptor on blood platelets, which contribute to blood clotting. Eptifibatide can also be used to prevent complications of angioplasty.

Product introduction, Anticoagulants (Medicine), Anticoagulants

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