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Fibrinolytics and Antifibrinolytics pp 473–492Cite as

Thrombus-Targeting of Plasminogen Activators

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Part of the book series: Handbook of Experimental Pharmacology ((HEP,volume 146))

Abstract

Large-scale studies with mortality endpoints comparing thrombolytic therapy with placebo in patients with acute myocardial infarction (AMI) have documented the benefit of timely dissolution of coronary arterial thrombi by intravenous infusion of plasminogen activators [Gruppo Italiano per lo Studio della Streptochinasi nell’Infarto miocardico (GISSI) 1986; Wilcox et al. 1988; Aims Trial Study Group 1988; The ISIS-2 (Second International Study of Infarct Survival) Collaborative Group 1988]. The GUSTO-1 trial (The GUSTO Investigators 1993), comparing four thrombolytic strategies, showed a small but noteworthy improvement (1.0%) in survival among patients treated with recombinant tissue-type plasminogen activator (tPA) compared with streptokinase (SK). Equally important with this incremental improvement in survival was the finding that there is a direct correlation between early and complete reperfusion and survival (The GUSTO Angiographic Investigators 1993). These data are consistent with the hypothesis that fibrin-specific thrombolytic agents achieve lower mortality by lysing coronary thrombi more rapidly and more completely. The results of the GUSTO trial thus appear to give reasonable direction to researchers involved in the design of plasminogen activators with improved potency and specificity.

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  1. C. Bode
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  2. K. Peter
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  3. M. S. Runge
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  4. E. Haber
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Editors and Affiliations

  1. FRAT — Hôpital Nestlé 2077, CHUV, CH-1011, Lausanne, Switzerland

    F. Bachmann

  2. Chemin Praz Mandry 20, CH-1052, Le Mont, Switzerland

    F. Bachmann

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Bode, C., Peter, K., Runge, M.S., Haber, E. (2001). Thrombus-Targeting of Plasminogen Activators. In: Bachmann, F. (eds) Fibrinolytics and Antifibrinolytics. Handbook of Experimental Pharmacology, vol 146. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-56637-0_18

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  • DOI: https://doi.org/10.1007/978-3-642-56637-0_18

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