What do new lytics add to t-PA?

Abstract	Current thrombolytic therapy fails to induce early, complete, and sustained reperfusion in +/-50% of the patients with ST-segment elevation acute coronary syndromes. There are two complementary approaches to improve thrombolytic therapy: the development of new fibrinolytics with enhanced fibrin specificity and/or reduced plasma clearance and the coadministration of new antithrombotic agents. The results obtained so far suggest that single-bolus fibrinolytic therapy is likely to replace the current infusions in the near future. This may result in a significantly earlier (prehospital) treatment of patients. The concomitant intravenous administration of a glycoprotein IIb/IIIa receptor antagonist (in combination with a reduced dose of a fibrinolytic) appears to be able to further enhance the efficacy for clot lysis without increasing the risk for bleeding complications.
Authors	F Van de Werf
Journal	American heart journal (Am Heart J) Vol. 138 Issue 2 Pt 2 Pg. S115-20 (Aug 1999) ISSN: 0002-8703 [Print] United States
PMID	10426869 (Publication Type: Journal Article, Review)
Chemical References	Fibrinolytic Agents Platelet Glycoprotein GPIIb-IIIa Complex Platelet Glycoprotein GPIb-IX Complex Platelet Membrane Glycoproteins Receptors, Antigen, B-Cell Receptors, Cell Surface glycoprotein receptor GPIb-IX Fibrin Tissue Plasminogen Activator
Topics	Coronary Disease (drug therapy) Fibrin (antagonists & inhibitors) Fibrinolytic Agents (therapeutic use) Hemorrhage (prevention & control) Humans Injections, Intravenous Metabolic Clearance Rate Myocardial Infarction (drug therapy) Myocardial Reperfusion (methods) Platelet Glycoprotein GPIIb-IIIa Complex (antagonists & inhibitors) Platelet Glycoprotein GPIb-IX Complex Platelet Membrane Glycoproteins Receptors, Antigen, B-Cell (antagonists & inhibitors) Receptors, Cell Surface (antagonists & inhibitors) Substrate Specificity Thrombolytic Therapy Time Factors Tissue Plasminogen Activator (therapeutic use)

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