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Tissue-type plasminogen activator is a naturally occurring, clot-selective activator of fibrinolysis. We recently reported that human tissue-type plasminogen activator isolated from a Bowes-melanoma-tissue-culture supernate lysed coronary thrombi in dogs without depleting circulating fibrinogen or alpha 2-antiplasmin, in contrast to the case with streptokinase and urokinase. In the present study coronary thrombolysis, confirmed angiographically, was induced within 19 to 50 minutes with intravenous or intracoronary tissue-type plasminogen activator in six of seven patients with evolving myocardial infarction. Circulating fibrinogen, plasminogen, and alpha 2-antiplasmin were not depleted by this agent, in contrast to the case in the two patients subsequently given streptokinase. In the one patient in whom lysis was not inducible with tissue-type plasminogen activator, it was also not inducible with streptokinase. These observations indicate that clot-selective coronary thrombolysis can be induced in patients with evolving myocardial infarction by means of tissue-type plasminogen activator, without concomitant induction of a systemic lytic state. Definition of its therapeutic benefit must await greater availability of the agent and the performance of appropriate clinical trials.
F Van de Werf, and
P A Ludbrook, and
S R Bergmann, and
A J Tiefenbrunn, and
K A Fox, and
H de Geest, and
M Verstraete, and
D Collen, and
B E Sobel
February 1987,
Cardiology clinics,
F Van de Werf, and
P A Ludbrook, and
S R Bergmann, and
A J Tiefenbrunn, and
K A Fox, and
H de Geest, and
M Verstraete, and
D Collen, and
B E Sobel
June 1984,
The New England journal of medicine,
F Van de Werf, and
P A Ludbrook, and
S R Bergmann, and
A J Tiefenbrunn, and
K A Fox, and
H de Geest, and
M Verstraete, and
D Collen, and
B E Sobel
January 1986,
JAMA,
F Van de Werf, and
P A Ludbrook, and
S R Bergmann, and
A J Tiefenbrunn, and
K A Fox, and
H de Geest, and
M Verstraete, and
D Collen, and
B E Sobel
November 1986,
Circulation,
F Van de Werf, and
P A Ludbrook, and
S R Bergmann, and
A J Tiefenbrunn, and
K A Fox, and
H de Geest, and
M Verstraete, and
D Collen, and
B E Sobel
May 1988,
Arquivos brasileiros de cardiologia,
F Van de Werf, and
P A Ludbrook, and
S R Bergmann, and
A J Tiefenbrunn, and
K A Fox, and
H de Geest, and
M Verstraete, and
D Collen, and
B E Sobel
May 1988,
Circulation,
F Van de Werf, and
P A Ludbrook, and
S R Bergmann, and
A J Tiefenbrunn, and
K A Fox, and
H de Geest, and
M Verstraete, and
D Collen, and
B E Sobel
October 1984,
Circulation,
F Van de Werf, and
P A Ludbrook, and
S R Bergmann, and
A J Tiefenbrunn, and
K A Fox, and
H de Geest, and
M Verstraete, and
D Collen, and
B E Sobel
December 1984,
Texas Heart Institute journal,
F Van de Werf, and
P A Ludbrook, and
S R Bergmann, and
A J Tiefenbrunn, and
K A Fox, and
H de Geest, and
M Verstraete, and
D Collen, and
B E Sobel
June 1983,
Science (New York, N.Y.),
F Van de Werf, and
P A Ludbrook, and
S R Bergmann, and
A J Tiefenbrunn, and
K A Fox, and
H de Geest, and
M Verstraete, and
D Collen, and
B E Sobel
November 1985,
European heart journal,
