New approaches to the management of AMI

Fibrinolysis plus GP IIb/IIIa receptor blockade

Research output: Contribution to journalReview article

Abstract

Current thrombolytic regimens improve survival of patients with acute myocardial infarction but have shortcomings, including inadequate rates of complete reperfusion, reocclusion after clot lysis, and bleeding complications. Genetically engineered mutants of tissue-plasminogen activator (t-PA) can be administered by bolus rather than infusion. These newer agents have not shown definitive clinical improvements over t-PA, but they have practical and economic advantages and the potential to reduce medication errors. Platelet glycoprotein (GP) IIb/IIIa receptor inhibitors, a class of potent antiplatelet agents, are successful in treating patients with acute coronary syndromes both within and outside the catheterization laboratory. The combination of thrombolytic agents with GP IIb/IIIa inhibitors has produced encouraging results in pilot phase-II dose-ranging and angiographic trials. Combination therapy has produced higher Thrombolysis in Myocardial Infarction (TIMI) 3 flow rates than either therapy alone. Optimal benefits, including meaningful reductions in bleeding complications, depend on further refinements to the doses of both thrombolytics and the adjunctive heparin regimens used in combination therapy.

Original languageEnglish
Pages (from-to)738-751
Number of pages14
JournalFormulary
Volume35
Issue number9
StatePublished - 2000

Fingerprint

Platelet Glycoprotein GPIIb-IIIa Complex
Fibrinolysis
Tissue Plasminogen Activator
Myocardial Infarction
Hemorrhage
Integrin beta3
Medication Errors
Fibrinolytic Agents
Platelet Aggregation Inhibitors
Acute Coronary Syndrome
Catheterization
Reperfusion
Heparin
Therapeutics
Economics
Survival

All Science Journal Classification (ASJC) codes

  • Pharmaceutical Science

Cite this

New approaches to the management of AMI : Fibrinolysis plus GP IIb/IIIa receptor blockade. / Hilleman, Daniel E.

In: Formulary, Vol. 35, No. 9, 2000, p. 738-751.

Research output: Contribution to journalReview article

@article{31ab3cd3777340ecbf8998c0b4f35cc1,
title = "New approaches to the management of AMI: Fibrinolysis plus GP IIb/IIIa receptor blockade",
abstract = "Current thrombolytic regimens improve survival of patients with acute myocardial infarction but have shortcomings, including inadequate rates of complete reperfusion, reocclusion after clot lysis, and bleeding complications. Genetically engineered mutants of tissue-plasminogen activator (t-PA) can be administered by bolus rather than infusion. These newer agents have not shown definitive clinical improvements over t-PA, but they have practical and economic advantages and the potential to reduce medication errors. Platelet glycoprotein (GP) IIb/IIIa receptor inhibitors, a class of potent antiplatelet agents, are successful in treating patients with acute coronary syndromes both within and outside the catheterization laboratory. The combination of thrombolytic agents with GP IIb/IIIa inhibitors has produced encouraging results in pilot phase-II dose-ranging and angiographic trials. Combination therapy has produced higher Thrombolysis in Myocardial Infarction (TIMI) 3 flow rates than either therapy alone. Optimal benefits, including meaningful reductions in bleeding complications, depend on further refinements to the doses of both thrombolytics and the adjunctive heparin regimens used in combination therapy.",
author = "Hilleman, {Daniel E.}",
year = "2000",
language = "English",
volume = "35",
pages = "738--751",
journal = "Formulary",
issn = "1082-801X",
publisher = "Advanstar Communications",
number = "9",

}

TY - JOUR

T1 - New approaches to the management of AMI

T2 - Fibrinolysis plus GP IIb/IIIa receptor blockade

AU - Hilleman, Daniel E.

PY - 2000

Y1 - 2000

N2 - Current thrombolytic regimens improve survival of patients with acute myocardial infarction but have shortcomings, including inadequate rates of complete reperfusion, reocclusion after clot lysis, and bleeding complications. Genetically engineered mutants of tissue-plasminogen activator (t-PA) can be administered by bolus rather than infusion. These newer agents have not shown definitive clinical improvements over t-PA, but they have practical and economic advantages and the potential to reduce medication errors. Platelet glycoprotein (GP) IIb/IIIa receptor inhibitors, a class of potent antiplatelet agents, are successful in treating patients with acute coronary syndromes both within and outside the catheterization laboratory. The combination of thrombolytic agents with GP IIb/IIIa inhibitors has produced encouraging results in pilot phase-II dose-ranging and angiographic trials. Combination therapy has produced higher Thrombolysis in Myocardial Infarction (TIMI) 3 flow rates than either therapy alone. Optimal benefits, including meaningful reductions in bleeding complications, depend on further refinements to the doses of both thrombolytics and the adjunctive heparin regimens used in combination therapy.

AB - Current thrombolytic regimens improve survival of patients with acute myocardial infarction but have shortcomings, including inadequate rates of complete reperfusion, reocclusion after clot lysis, and bleeding complications. Genetically engineered mutants of tissue-plasminogen activator (t-PA) can be administered by bolus rather than infusion. These newer agents have not shown definitive clinical improvements over t-PA, but they have practical and economic advantages and the potential to reduce medication errors. Platelet glycoprotein (GP) IIb/IIIa receptor inhibitors, a class of potent antiplatelet agents, are successful in treating patients with acute coronary syndromes both within and outside the catheterization laboratory. The combination of thrombolytic agents with GP IIb/IIIa inhibitors has produced encouraging results in pilot phase-II dose-ranging and angiographic trials. Combination therapy has produced higher Thrombolysis in Myocardial Infarction (TIMI) 3 flow rates than either therapy alone. Optimal benefits, including meaningful reductions in bleeding complications, depend on further refinements to the doses of both thrombolytics and the adjunctive heparin regimens used in combination therapy.

UR - http://www.scopus.com/inward/record.url?scp=0033832870&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033832870&partnerID=8YFLogxK

M3 - Review article

VL - 35

SP - 738

EP - 751

JO - Formulary

JF - Formulary

SN - 1082-801X

IS - 9

ER -