New Thrombolytic Agents

摘要: In over 90% of cases, a thrombotic occlusion coronary artery is the cause an acute myocardial infarction (AMI) (1). Thrombolytic therapy has been shown to reduce short- and long-term mortality AMI patients (2). As result several large placebo-controlled trials, thrombolysis become routine treatment in presenting within 6–12 h after symptom onset with ST elevations or bundle branch block on electrocardiogram (ECG). The aim thrombolytic achieve early (within 30–90 min), complete (TIMI grade 3 flow), sustained restoration blood flow infarct-related artery. This “optimal reperfusion” associated remarkably low in-hospital 3–4% (3, 4). more rapid flow, better clinical outcome (Fig. 1). However, even most effective regimens available, perfusion can be achieved only 50–60% (5, 6). Besides initial failure reperfusion, reocclusion primarily successful (occuring up 15%) bleeding complications (especially intracranial bleeding, observed 0.5–1.0%) are current problems therapy. ideal agent should highly (high reperfusion rate), safe (low rate hemorrhagic complications, e.g., bleeding), easy administer (single-bolus application), cheap. widely used worldwide, streptokinase, limited efficacy regard patency, major side effects (including hypotension), must infused at least 30 min (7). Recombinant tissue-type plasminogen activator (tPA; alteplase) achieves higher rates patency but necessitates rather complicated dose regimen optimal (4, 8). Therefore search for new still ongoing (9–11).