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streptokinase versus alteplase in stroke

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https://www.readbyqxmd.com/read/23074449/primary-angioplasty-for-the-treatment-of-acute-st-segment-elevated-myocardial-infarction-an-evidence-based-analysis
#1
(no author information available yet)
One of the longest running debates in cardiology is about the best reperfusion therapy for patients with evolving acute myocardial infarction (MI). Percutaneous transluminal coronary angioplasty (ANGIOPLASTY) is a surgical treatment to reopen a blocked coronary artery to restore blood flow. It is a type of percutaneous (through-the-skin) coronary intervention (PCI) also known as balloon angioplasty. When performed on patients with acute myocardial infarction, it is called primary angioplasty. Primary angioplasty is an alternative to thrombolysis, clot-dissolving drug therapy, for patients with acute MI associated with ST-segment elevation (STEMI), a change recorded with an electrocardiogram (ECG) during chest pain...
2004: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/18673235/fibrin-binding-and-the-regulation-of-plasminogen-activators-during-thrombolytic-therapy
#2
REVIEW
C Longstaff, S Williams, C Thelwell
First generation thrombolytics (streptokinase and urokinase) had no fibrin binding capabilities and caused systemic plasminogen activation with concomitant destruction of haemostatic proteins. A primary driving force behind the development of the second generation plasminogen activator tissue plasminogen activator (tPA or alteplase) was its ability to bind to fibrin and target thrombolysis. Although in vitro assays highlighted advantages of fibrin binding, clinical trials were disappointing, showing only small benefits in mortality with tPA versus streptokinase, but also with some increase in haemorrhagic stroke...
July 2008: Cardiovascular & Hematological Agents in Medicinal Chemistry
https://www.readbyqxmd.com/read/17263591/spotlight-on-reteplase-in-thrombotic-occlusive-disorders
#3
REVIEW
Dene Simpson, M Asif A Siddiqui, Lesley J Scott, Daniel E Hilleman
Reteplase (Retavase) is a plasminogen activator, mimicking endogenous tissue plasminogen activator (t-PA), a serine protease, converting plasminogen to plasmin and thereby precipitating thrombolysis. It is a third-generation recombinant form of t-PA that operates in the presence of fibrin (i.e. it is fibrin specific). Reteplase can be administered as a bolus dose (nonweight-based), rather than an infusion, which promotes rapid and safe administration. The ease of administration of this reteplase dosage regimen (two 10U bolus doses, each over 2 minutes, 30 minutes apart) is conducive to prehospital initiation of thrombolytic treatment in patients with ST-segment elevation myocardial infarction (STEMI), which reduces the time to treatment, a critical factor in improving long-term survival...
2007: BioDrugs: Clinical Immunotherapeutics, Biopharmaceuticals and Gene Therapy
https://www.readbyqxmd.com/read/16913828/reteplase-a-review-of-its-use-in-the-management-of-thrombotic-occlusive-disorders
#4
REVIEW
Dene Simpson, M Asif A Siddiqui, Lesley J Scott, Daniel E Hilleman
Reteplase (Retavase) is a plasminogen activator, mimicking endogenous tissue plasminogen activator (t-PA), a serine protease, converting plasminogen to plasmin and thereby precipitating thrombolysis. It is a third-generation recombinant form of t-PA that operates in the presence of fibrin (i.e. it is fibrin specific). Reteplase can be administered as a bolus dose (nonweight-based) rather than an infusion, which promotes rapid and safe administration. The ease of administration of this reteplase dosage regimen (two 10U bolus doses, each over 2 minutes, 30 minutes apart) is conducive to prehospital initiation of thrombolytic treatment in patients with ST-segment elevation myocardial infarction (STEMI), which reduces the time to treatment, a critical factor in improving long-term survival...
2006: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/15526522/double-bolus-of-0-75-mu-streptokinase-plus-enoxaparin-versus-front-loaded-alteplase-plus-unfractionated-heparin-in-st-segment-elevation-myocardial-infarction
#5
COMPARATIVE STUDY
G Tatu-Chiţoiu, Cristina Teodorescu, Monica Dan, P Căpraru, Manuela Guran, Oana Istrătescu, Alexandrina Tatu-Chiţoiu, Aurelia Bumbu, Maria Dorobanţu
OBJECTIVE: To compare the efficacy and safety of an accelerated streptokinase regimen (double bolus of 0.75 MU in 10 min) in combination with enoxaparin (SK0.75Enox regimen) with the one of the front loaded alteplase (t-PA 100 mg/90 min) plus heparin (the t-PAHep regimen) in patients (pts.) with ST-segment elevation acute myocardial infarction (STAMI). METHODS: One hundred seventy three pts. (age 18-74) treated within the first 6 hrs. after the onset of STAMI with the above two mentioned thrombolytic regimens were included...
2003: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
https://www.readbyqxmd.com/read/10342921/reteplase-new-preparation-minimal-value-bolus-versus-infusion
#6
COMPARATIVE STUDY
(no author information available yet)
The clinical file on reteplase is methodologically sound. A trial versus alteplase involving more than 15 000 patients seen less than 6 hours after myocardial infarction showed that mortality at 30 days was identical in the reteplase and alteplase treatment groups (7.3%). The two treatment groups did not differ either in the frequency of strokes or severe bleeding. Another trial involving more than 6 000 patients seen less than 12 hours after myocardial infarction showed that overall mortality 35 days after thrombolysis was 9% in both the reteplase and the streptokinase treatment groups...
June 1998: Prescrire International
https://www.readbyqxmd.com/read/9562007/comparative-efficacy-of-a-two-hour-regimen-of-streptokinase-versus-alteplase-in-acute-massive-pulmonary-embolism-immediate-clinical-and-hemodynamic-outcome-and-one-year-follow-up
#7
RANDOMIZED CONTROLLED TRIAL
N Meneveau, F Schiele, D Metz, B Valette, P Attali, A Vuillemenot, G Grollier, J Elaerts, J M Mossard, J F Viel, J P Bassand
OBJECTIVES: This study sought to compare the efficacy of 2-h regimens of alteplase and streptokinase in acute massive pulmonary embolism. The primary end point was immediate hemodynamic improvement, and secondary end points included early clinical efficacy and safety, as well as 1-year clinical outcome. BACKGROUND: Several thrombolytic regimens have been compared for the past 10 years in randomized studies, showing that 2-h infusion regimens of alteplase or urokinase lead to faster hemodynamic improvement than former 12- to 24-h administration protocols in acute massive pulmonary embolism...
April 1998: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/8578440/thrombolytic-therapy-overview-of-results-in-major-vascular-occlusions
#8
REVIEW
V J Marder
Thrombolytic therapy provides clinical benefit in patients with vascular occlusions, depending upon the organ or limb that is threatened. The impact of therapeutic intervention varies from the quiet alteration of the course of deep vein thrombosis, for which non-life threatening post-phlebitic syndrome can be largely avoided, to the sometimes striking reversal of pulmonary hypertension and possible life-saving benefit in massive pulmonary embolism, the immediate alteration of clinical course in acute peripheral arterial occlusion by reducing the need for surgical intervention, cardiopulmonary complication and one year mortality, and finally to the dramatic and life-saving potential when applied in patients with acute myocardial infarction...
July 1995: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/1975322/in-hospital-mortality-and-clinical-course-of-20-891-patients-with-suspected-acute-myocardial-infarction-randomised-between-alteplase-and-streptokinase-with-or-without-heparin-the-international-study-group
#9
RANDOMIZED CONTROLLED TRIAL
(no author information available yet)
In a study with 2 x 2 factorial design, 20,891 patients with suspected acute myocardial infarction of less than 6 h duration (12,490 from the GISSI-2 trial and 8401 recruited elsewhere) were randomly allocated to alteplase (recombinant tissue plasminogen activator, tPA) or streptokinase (SK) and to subcutaneous heparin, beginning 12 h after the start of thrombolytic therapy or no heparin. The protocol recommended that, in the absence of specific contraindications, all patients should receive aspirin and intravenous beta-blockade as soon as possible...
July 14, 1990: Lancet
https://www.readbyqxmd.com/read/1975321/gissi-2-a-factorial-randomised-trial-of-alteplase-versus-streptokinase-and-heparin-versus-no-heparin-among-12-490-patients-with-acute-myocardial-infarction-gruppo-italiano-per-lo-studio-della-sopravvivenza-nell-infarto-miocardico
#10
RANDOMIZED CONTROLLED TRIAL
(no author information available yet)
A multicentre, randomised, open trial with a 2 x 2 factorial design was conducted to compare the benefits and risks of two thrombolytic agents, streptokinase (SK, 1.5 MU infused intravenously over 30-60 min) and alteplase (tPA, 100 mg infused intravenously over 3 h) in patients with acute myocardial infarction admitted to coronary care units within 6 h from onset of symptoms. The patients were also randomised to receive heparin (12,500 U subcutaneously twice daily until discharge from hospital, starting 12 h after beginning the tPA or SK infusion) or usual therapy...
July 14, 1990: Lancet
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