Coronary revascularization after intravenous tissue plasminogen activator for unstable angina pectoris: Results of a randomized, double-blind, placebo-controlled trial
dc.contributor.author | Topol, Eric J. | en_US |
dc.contributor.author | Nicklas, John M. | en_US |
dc.contributor.author | Kander, Nathan H. | en_US |
dc.contributor.author | Walton, Joseph A. | en_US |
dc.contributor.author | Ellis, Stephen G. | en_US |
dc.contributor.author | Gorman, Laura | en_US |
dc.contributor.author | Pitt, Bertram | en_US |
dc.date.accessioned | 2006-04-07T20:12:48Z | |
dc.date.available | 2006-04-07T20:12:48Z | |
dc.date.issued | 1988-09-01 | en_US |
dc.identifier.citation | Topol, Eric J., Nicklas, John M., Kander, Nathan H., Walton, Joseph A., Ellis, Stephen G., Gorman, Laura, Pitt, Bertram (1988/09/01)."Coronary revascularization after intravenous tissue plasminogen activator for unstable angina pectoris: Results of a randomized, double-blind, placebo-controlled trial." The American Journal of Cardiology 62(7): 368-371. <http://hdl.handle.net/2027.42/27162> | en_US |
dc.identifier.uri | http://www.sciencedirect.com/science/article/B6T10-4C70869-67/2/70be8957b834e1dfd337b62ae880bc42 | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/27162 | |
dc.identifier.uri | http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=2970776&dopt=citation | en_US |
dc.description.abstract | To determine the role of intravenous tissue plasminogen activator (t-PA) in unstable angina, it was compared with placebo in a randomized, double-blind trial. Forty patients with angina at rest and provocable ischemia (pacing induced) had baseline coronary angiography, study drug infusion and then repeat angiography at 20 +/- 9 hours. All patients received diltiazem, nitrates, [beta] blockers, aspirin and intravenous heparin. During study drug infusion (150 mg over 8 hours), refractory ischemia necessitating emergency bypass surgery (CABG) or coronary angioplasty (PTCA) occurred in 4 of 20 t-PA patients compared with 1 of 20 placebo patients (p = 0.21). Before discharge, revascularization for persistent, provocable ischemia and a residual stenosis >= 60% was as follows: t-PA patients, 8 PTCA and 7 CABG; placebo patients, 11 PTCA and 8 CABG (p = 0.39). Quantitative angiographic percent diameter stenosis of the culprit artery at baseline and follow-up was: t-PA 71 +/- 17 and 63 +/- 22; placebo 70 +/- 19 and 67 +/- 22 (difference not significant). However, 3 t-PA patients compared with no placebo patients demonstrated an insignificant (< 60% diameter) residual stenosis and averted PTCA (p = 0.14). There were no complications of PTCA in the 8 t-PA patients; in contrast, 3 of 11 placebo patients had abrupt closure, necessitating emergency CABG in 2 (p = 0.23). Thus, intravenous t-PA in unstable angina can eliminate the need for PTCA in a few patients, does not appear to decrease the overall or emergency rate of revascularization procedures and may facilitate the safety of PTCA. | en_US |
dc.format.extent | 2565366 bytes | |
dc.format.extent | 3118 bytes | |
dc.format.mimetype | application/pdf | |
dc.format.mimetype | text/plain | |
dc.language.iso | en_US | |
dc.publisher | Elsevier | en_US |
dc.title | Coronary revascularization after intravenous tissue plasminogen activator for unstable angina pectoris: Results of a randomized, double-blind, placebo-controlled trial | en_US |
dc.type | Article | en_US |
dc.rights.robots | IndexNoFollow | en_US |
dc.subject.hlbsecondlevel | Internal Medicine and Specialties | en_US |
dc.subject.hlbtoplevel | Health Sciences | en_US |
dc.description.peerreviewed | Peer Reviewed | en_US |
dc.contributor.affiliationum | Division of Cardiology, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, Michigan, USA | en_US |
dc.contributor.affiliationum | Division of Cardiology, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, Michigan, USA | en_US |
dc.contributor.affiliationum | Division of Cardiology, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, Michigan, USA | en_US |
dc.contributor.affiliationum | Division of Cardiology, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, Michigan, USA | en_US |
dc.contributor.affiliationum | Division of Cardiology, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, Michigan, USA | en_US |
dc.contributor.affiliationum | Division of Cardiology, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, Michigan, USA | en_US |
dc.contributor.affiliationum | Division of Cardiology, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, Michigan, USA | en_US |
dc.identifier.pmid | 2970776 | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/27162/1/0000157.pdf | en_US |
dc.identifier.doi | http://dx.doi.org/10.1016/0002-9149(88)90960-5 | en_US |
dc.identifier.source | The American Journal of Cardiology | en_US |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
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