Comparison of two dose regimens of intravenous tissue plasminogen activator for acute myocardial infarction
dc.contributor.author | Topol, Eric J. | en_US |
dc.contributor.author | George, Barry S. | en_US |
dc.contributor.author | Kereiakes, Dean J. | en_US |
dc.contributor.author | Candela, Richard J. | en_US |
dc.contributor.author | Abbottsmith, Charles W. | en_US |
dc.contributor.author | Stump, David C. | en_US |
dc.contributor.author | Boswick, Jane M. | en_US |
dc.contributor.author | Stack, Richard S. | en_US |
dc.contributor.author | Califf, Robert M. | en_US |
dc.date.accessioned | 2006-04-07T20:21:48Z | |
dc.date.available | 2006-04-07T20:21:48Z | |
dc.date.issued | 1988-04-01 | en_US |
dc.identifier.citation | Topol, Eric J., George, Barry S., Kereiakes, Dean J., Candela, Richard J., Abbottsmith, Charles W., Stump, David C., Boswick, Jane M., Stack, Richard S., Califf, Robert M. (1988/04/01)."Comparison of two dose regimens of intravenous tissue plasminogen activator for acute myocardial infarction." The American Journal of Cardiology 61(10): 723-728. <http://hdl.handle.net/2027.42/27366> | en_US |
dc.identifier.uri | http://www.sciencedirect.com/science/article/B6T10-4C708K5-GB/2/66877f0a73451d8a1a36555137d20bad | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/27366 | |
dc.identifier.uri | http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=2965504&dopt=citation | en_US |
dc.description.abstract | Two dosing schedules of intravenous tissue plasminogen activator (t-PA) for acute myocardial infarction were compared in a multicenter trial. At 2.95 +/- 1.1 hours from onset of chest pain, 386 patients received 150 mg of intravenous t-PA. For the first 178 patients (group A), 60 mg were given in the first-hour dose and the remaining 90 mg were infused over 7 hours. In the subsequent 208 patients (group B), the first-hour dose was 1.0 mg/kg and the remaining 150 mg were given over 5 hours. At initial angiography 94 +/- 30 minutes into therapy, the infarct vessel patency was 64% in group A versus 75% in group B (p = 0.02). By final angiography with up to 4 selective contrast injections, patency was 68% versus 77%, respectively (p = 0.06). Repeat angiography at 7 to 10 days demonstrated reocclusion in 17% of group A and 13% of group B patients (p = 0.35). There was no difference in fibrinogen nadir or mean hematocrit drop between the 2 groups: 120 mg/dl and 11 points, respectively, in group A compared with 120 mg/dl and 10 points in group B. However, bleeding was reduced in group B patients as evident by a decrease in requirement for >=2 units of packed red blood cell transfusion (group A 36%, group B 27%, P = 0.05) and lower incidence of gastrointestinal bleeding (group A 12%, group B 4%, P = 0.002). To further study the importance of weight adjustment, patients were divided into 2 groups according to weight (=90 kg). According to the results, lighter weight patients had greater transfusion requirements (35% versus 20%, P = 0.006) and more frequent major bleeding episodes (16% versus 7%, P = 0.025). Thus, a higher, weight-adjusted first-hour dose of intravenous t-PA, with a shorter duration of maintenance infusion, is associated with: (1) improved infarct vessel patency; (2) more rapid recanalization; and (3) less bleeding complications without more fibrinogenolysis. | en_US |
dc.format.extent | 781847 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 | Comparison of two dose regimens of intravenous tissue plasminogen activator for acute myocardial infarction | 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 | From the Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, Michigan, USA | en_US |
dc.contributor.affiliationum | From the Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, Michigan, USA | en_US |
dc.contributor.affiliationum | From the Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, Michigan, USA | en_US |
dc.contributor.affiliationum | From the Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, Michigan, USA | en_US |
dc.contributor.affiliationum | From the Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, Michigan, USA | en_US |
dc.contributor.affiliationum | From the Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, Michigan, USA | en_US |
dc.contributor.affiliationum | From the Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, Michigan, USA | en_US |
dc.contributor.affiliationum | From the Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, Michigan, USA | en_US |
dc.contributor.affiliationum | From the Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, Michigan, USA | en_US |
dc.identifier.pmid | 2965504 | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/27366/1/0000392.pdf | en_US |
dc.identifier.doi | http://dx.doi.org/10.1016/0002-9149(88)91055-7 | en_US |
dc.identifier.source | The American Journal of Cardiology | en_US |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
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