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Importance of thrombolytic therapy for restoration of coronary blood flow in acute myocardial infarction is emphasized. Indications and contraindications, advantages and disadvantages for thrombolysis therapy are discussed. The ways of different thrombolytics implementation, efficacy criteria and possible side effects are also presented.

About the Author

D. P. Sementsov
City Clinical Hospital №59, Moscow
Russian Federation

Cardio Emergency Unit


1. Norris R.M., Caughey D.E., Mercer C.J., Scott P.J. Prognosis after myocardial infarction. Six-year follow-up. Br Heart J 1974:36:786-90.

2. De Vreede J.J., Gorgels A.P., Verstraaten G.M., et al. Did prognosis after acute myocardial infarction change during the past 30 years? A meta￾analysis. J Am Coll Cardiol 1991;18(3): 698-706.

3. Hasai D., Begar S., Wallentin L., et al. A prospective survey of the characteristics, treatments and outcomes of patient with acute coronary syn￾dromes in Europe and the Mediterranean basin. The Euro Heart Survey of Acute Coronary Syndromes (Euro Heart Survey ACS). Eur Heart J 2002;15:1190-201.

4. Davies M.J. The pathophysiology of acute coronary syndromes. Heart 2000;83:361-6.

5. Antman E.M., Anbe D.T., Armstrong P.W., Bates E.R., Green L.A., Hand M. et al. ACC/AHA Guidelines for the Management of Patients With STElevation Myocardial Infarction – Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction). Circulation 2004;110:588-636.

6. The ASSENT-2 Investigators. Single-bolus tenecteplase compared with front-loaded alteplase in acute myocardial infarction: the ASSENT-2 double-blind randomized trial. Assessment of the Safety and Efficacy of a New Thrombolytic Investigators. Lancet 1999;354:716-22.

7. Welsh R.C., Ornato J., Armstrong P.W. Prehospital management of acute ST-elevation myocardial infarction: A time for reappraisal in North America. Am Heart J 2003;145:1-8.

8. Boersma E., Maas A.C., Deckers J.W., et al. Early thrombolytic treatment in acute myocardial infarction: reappraisal of the golden hour. Lancet 1996;348:771-5.

9. Weaver W.D., Cerqueira M., Hallstrom A.P., et al. Pre-hospital-initiated vs hospital-initiated thrombolytic therapy: the Myocardial Infarction Triage and Interventional Trial. JAMA 1993;270(10):1211-6.

10. Fu Y., Goodman S., Chang W.C., et al. Time to treatment influences the impact of ST-segment resolution on one-year prognosis: insight from the assessment of the safety and efficacy of a new thrombolytic (ASSENT-2) trial. Circulation 2001;104:2653-9.

11. Schroder R., Dissmann R., Bruggemann T., et al. Extent of early ST segment elevation resolution: a simple but strong predictor of outcome in patients with acute myocardial infarction. J Am Coll Cardiol 1994;24(2):384-91.

12. Anderson D.R., White H.D., Ohman M.E., et al. Predicting outcome after thrombolysis in acute myocardial infarction according to ST-segment resolution at 90 minutes: a substudy of the GUSTO III trial. Am Heart J 2002;144:81-8.

13. Roux S., Christeller S., Ludin E. Effects of aspirin on coronary reocclusion and recurrent ischemia after thrombolysis: a meta-analysis. J Am Coll Cardiol 1992;19:671-7.

14. Antithrombotic Trialists Collaboration. Collaborative meta-analysis of randomized trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high-risk patients. BMJ 2002;324:71- 86.

15. The Assessment of the Safety and Efficacy of a New Fibrinolytic Regimen (ASSENT-3) Investigators. Efficacy and safety of tenecteplase in combination with Enoxaparin, abciximab, or unfractionated heparin: the ASSENT-3 randomized trial in acute myocardial infarction. Lancet 2001;358:605-13.

16. The TIMI Study Group. Comparison of invasive and conservative strategies after treatment with intravenous tissue plasminogen activator in acute myocardial infarction: results of the thrombolysis in myocardial infarction (TIMI) phase II trial. N Engl J Med 1989;320:618-27.

17. Mehta S., Eikelboom J.W., Yusuf S. Risk of intracranial hemorrhage with bolus versus infusion thrombolytic therapy: a meta-analysis. Lancet 2000; 356: 449-54.

18. Zabel K.M., Granger C.V., Becker R.C., et al. Use of bedside activated partial thromboplastin time monitor to adjust UHF dosing after thrombolysis for acute myocardial infarction: results of GUSTO-I. Global Utilization of Streptokinase and TPA for Occluded Coronary Arteries. Am Heart J 1998;136:868-76.

19. A clinical trial comparing coronary angioplasty with tissue plasminogen activator for acute myocardial infarction: the Global Use of Strategies to Open Occluded Coronary Arteries in Acute Coronary Syndromes (GUSTO IIb) Angioplasty Substudy Investigators. N Engl J Med 1997;336:1621-8.

20. The COBALT Investigators. A comparison of continuous infusion of alteplase with double-bolus administration for acute myocardial infarction: the Continuous Infusion versus Double-Bolus Administration of Alteplase (COBALT) investigators. N Engl J Med 1997;337:1124-30.

21. A comparison of reteplase with alteplase for acute myocardial infarction: the Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO III) investigators. N Engl J Med 1997;337:1118-23.

22. Mahaffey K.W., Lee K.L., White H.D., et al. Intracranial hemorrhage on the increase and beyond predicted levels: serial results from two large thrombolysis trials (abstract). Circulation 1999;100(suppl I):I-182.

23. Ferguson J.J. Highlights of the 48th Scientific Sessions of the American College of Cardiology. Circulation 1999;100:570-5.

24. Руда М.Я. Что нужно знать практическому врачу о тромболитической терапии при инфаркте микарда. Сердце 2002;(1):9-12.

25. Lee K.L., Woodlief L.H., Topol E.J., et al. Predictors of 30-day mortality in the era of reperfusion for acute myocardial infarction: Results From an International Trial of 41 021 Patients. Circulation 1995;91:1659- 68.

26. Califf R.M. Glycoprotein IIb/IIIa blockade and thrombolytics: early lessons from the SPEED and GUSTO IV trials. Am Heart J 1999;138(suppl):S12-5.

27. Morrison L.J., Verbeek P.R., McDonald A.C., et al. Mortality and prehospital thrombolysis for acute myocardial infarction: a meta-analy￾sis. JAMA 2000;283(20):2686-92.

28. Armstrong W., Collen D., Antman E. Fibrinolysis for Acute Myocardial Infarction. Circulation 2003;107:2533-7.

29. The GUSTO V Investigators. Reperfusion therapy for acute myocardial infarction with fibrinolytic therapy or combination reduced fibrinolytic therapy and platelet glycoprotein IIb/IIIa inhibition: the GUSTO V randomised trial. Lancet 2001;357:1905-14.

For citation:

Sementsov D.P. THROMBOLYTIC THERAPY OF ACUTE MYOCARDIAL INFARCTION. Rational Pharmacotherapy in Cardiology. 2007;3(5):73-78. (In Russ.)

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