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Tissue Plasminogen Activator (Alteplase)

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A proteolytic enzyme in the serine protease family found in many tissues which converts PLASMINOGEN to FIBRINOLYSIN. It has fibrin-binding activity and is immunologically different from UROKINASE-TYPE PLASMINOGEN ACTIVATOR. The primary sequence, composed of 527 amino acids, is identical in both the naturally occurring and synthetic proteases.

Also Known As:

Alteplase; Activase; T-Plasminogen Activator; Actilyse; Boehringer Ingelheim Brand of Alteplase; Genentech Brand of Alteplase; Hoffmann-La Roche Brand of Alteplase; Lysatec rt-PA; Promeco Brand of Alteplase; TTPA; Tisokinase; Tissue Activator D-44; Alteplase Genentech Brand; Alteplase Promeco Brand; Hoffmann La Roche Brand of Alteplase; Lysatec rt PA; Lysatec rtPA; Plasminogen Activator, Tissue; Plasminogen Activator, Tissue Type; T Plasminogen Activator; Tissue Activator D 44; Tissue Type Plasminogen Activator; Plasminogen Activator, Tissue-Type; Tissue-Type Plasminogen Activator

Networked: 6817 relevant articles (584 outcomes, 1223 trials/studies)

Relationship Network

Drug Context: Research Results

Experts

1.	Grotta, James C: 50 articles (07/2015 - 04/2002)
2.	Alexandrov, Andrei V: 49 articles (12/2015 - 01/2002)
3.	Hill, Michael D: 47 articles (12/2015 - 01/2002)
4.	Montaner, Joan: 43 articles (02/2015 - 06/2002)
5.	Demchuk, Andrew M: 42 articles (12/2015 - 01/2002)
6.	Kimura, Kazumi: 41 articles (01/2015 - 01/2004)
7.	Molina, Carlos A: 39 articles (12/2015 - 06/2002)
8.	Davis, Stephen M: 38 articles (08/2015 - 04/2003)
9.	Schwamm, Lee H: 37 articles (12/2015 - 11/2004)
10.	Broderick, Joseph P: 35 articles (12/2015 - 02/2004)

Related Diseases

1.	Stroke (Strokes) 09/01/2009 - "The submitted clinical evidence included several randomised controlled trials indicating that, in highly selected patients, alteplase administered at a licensed dose within 3 hours of the onset of acute ischaemic stroke is associated with a statistically significant reduction in the risk of death or dependency at 3 months compared with placebo, despite a significantly increased risk of symptomatic intracranial haemorrhage within the first 7-10 days. " 01/01/2005 - "Evidence from randomized clinical trials indicates that systemic administration of recombinant tissue plasminogen activator (rtPA) is a highly effective treatment for acute ischemic stroke, provided that treatment is administered within the first 3 h after stroke onset. " 11/29/2014 - "Alteplase is effective for treatment of acute ischaemic stroke but debate continues about its use after longer times since stroke onset, in older patients, and among patients who have had the least or most severe strokes. " 04/01/2014 - "Intravenous tissue plasminogen activator is the most effective treatment for acute ischemic stroke, and its use may therefore serve as an indicator of the available level of acute stroke care. " 01/01/2014 - "The efficacy of alteplase in acute ischaemic stroke (AIS) is highly time dependent. "
2.	Myocardial Infarction 06/01/1992 - "In this Bolus Dose-Escalation Study of Tissue-Type Plasminogen Activator (BEST), the efficacy of 3 different doses of a single rapid intravenous bolus injection of t-PA (dute-plase, Wellcome Foundation, London) in inducing coronary patency (Thrombolysis In Myocardial Infarction perfusion grade 2 or 3) in 64 patients with acute myocardial infarction presenting less than 6 hours after onset of symptoms was investigated. " 07/01/1995 - "Ideally, patients should receive alteplase as soon as possible after the onset of symptoms of acute myocardial infarction and, while therapy is most beneficial when administered early, survival is improved when the drug is administered up to 12 hours after symptom onset. " 01/01/1994 - "Efficacy of 100 mg of double-bolus alteplase in achieving complete perfusion in the treatment of acute myocardial infarction." 12/01/1990 - "This study assesses whether administration of recombinant tissue-type plasminogen activator (rt-PA) up to 8 hours after onset of symptoms of acute myocardial infarction (AMI) may result in a significant improvement in left ventricular function. " 04/01/1990 - "Improved infarct-related arterial patency after high dose, weight-adjusted, rapid infusion of tissue-type plasminogen activator in myocardial infarction: results of a multicenter randomized trial of two dosage regimens."
3.	Thrombosis (Thrombus) 09/01/2015 - "This case report describes a pregnant patient, whose echocardiogram showed evident gradient increase on her mechanical prosthetic mitral valve, and who was treated successfully with tissue plasminogen activator for mechanical valve thrombosis. " 09/01/2013 - "A neonatal thrombosis patient treated successfully with recombinant tissue plasminogen activator." 02/01/1995 - "Prosthetic valve thrombosis, a rare but fatal complication, can be successfully treated with tissue-type plasminogen activator and monitored by transthoracic and transesophageal echocardiography." 11/01/1989 - "We conclude that local infusion of tissue-type plasminogen activator is effective in lysing thromboses that may occur at the venous microvascular anastomotic site without significant activation of systemic fibrinolysis." 05/01/2013 - "Nanoparticle thrombus imaging was also effective in monitoring the therapeutic efficacy of thrombolysis (n=118 tissue plasminogen activator [tPA] therapies). "
4.	Hemorrhage 05/01/2013 - "Because of the short therapeutic time window, the risk of hemorrhage, and relatively limited efficacy of alteplase for large clot burden, research is ongoing to find more effective and safer reperfusion therapy, as well as focussing on refinement of patient selection for acute reperfusion treatment. " 06/01/1999 - "This improvement in reperfusion with alteplase occurred without an increase in the risk of major bleeding. " 10/01/2003 - "Intraventricular fibrinolysis with tissue plasminogen activator seems to be safe and effective for the treatment of intraventricular hemorrhage. " 10/01/2010 - "Recent efforts have been aimed at identifying new strategies that might enhance the thrombolytic efficacy of tissue plasminogen activator at the same time as reducing its associated complications related to hemorrhage and neurotoxicity. " 09/01/2011 - "The object of this study was to evaluate the safety and efficacy of ultrasound in combination with recombinant tissue plasminogen activator (rt-PA) delivered through a microcatheter directly into spontaneous intraventricular (IVH) or intracerebral (ICH) hemorrhage in humans. "
5.	Pulmonary Embolism 01/01/2008 - "Authors consider alteplase to be highly effective in the treatment of massive pulmonary embolism. " 12/01/1989 - "A case of pulmonary thromboembolism in a young woman three days status post-abdominal surgery is treated successfully with a low-dose infusion rate of tissue plasminogen activator (10 mg/hr over 10 h). " 01/01/2008 - "[The efficacy of alteplase in pulmonary embolism treatment]." 02/01/1988 - "To determine if pulmonary perfusion was improved in acute pulmonary embolism after therapy with recombinant human tissue-type plasminogen activator (rt-PA), lung scans were obtained before and a mean of 22 hours after therapy in 19 patients. " 12/01/2015 - "The aim of this study was to evaluate the association between admission CK-MB levels and in-hospital and long-term clinical outcomes in pulmonary embolism (PE) patients treated with thrombolytic tissue-plasminogen activator. "

Related Drugs and Biologics

1.	Tissue Plasminogen Activator (Alteplase)
2.	Urokinase-Type Plasminogen Activator (Urokinase)
3.	Streptokinase
4.	Heparin (Liquaemin)
5.	Plasminogen Activators (Plasminogen Activator)
6.	tenecteplase
7.	Fibrin
8.	Aspirin (Acetylsalicylic Acid)
9.	Plasminogen Activator Inhibitor 1
10.	4- Acetamido- 4'- isothiocyanatostilbene- 2,2'- disulfonic Acid (SITS)

Related Therapies and Procedures

1.	Thrombolytic Therapy
2.	Catheters
3.	Injections
4.	Vitrectomy
5.	Angioplasty (Angioplasty, Transluminal)