The use of thrombolytic agents in acute myocardial infarction (AMI) patients

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Abstract

What is known: Rapid restoration of patency of the infarct-related artery is the key to preserving myocardium and improving survival in acute myocardial infarction (AMI). Controversy surrounding the efficacy and cost of thrombolytic agents has lent uncertainty to the choice of thrombolytic agents. Objective: The primary objective of this study was to assess the use of thrombolytic agents in AMI, including time to treatment, and types, efficacy, and adverse effects of thrombolytic agents employed. Methods: Patients who were hospitalised with AMI over the past two years from January 2007 to December 2008 were involved. Medical records were retrospectively reviewed. Results: The thrombolytic agents were most commonly given within two to four hours (42.85%) of symptom onset and were rarely given after 12 hours (11.43%). A negative correlation was found between time to treatment and creatine kinase (CK) reduction [r(33) = -0.27, p>0.05]. The majority of the patients were given streptokinase. No significant differences were found between streptokinase and alteplase in CK reduction, duration of hospitalisation, and post-infarct residual heart function. Bleeding was the predominant adverse drug event reported in the alteplase treatment group. Streptokinase was associated with cardiovascular side effects and allergic reactions. What is New: The study included Malaysian patients. Conclusion: streptokinase and alteplase had similar efficacy in AMI patients. Other factors such as adverse effects should be considered when selecting a thrombolytic agent.

Original languageEnglish
Pages (from-to)63-67
Number of pages5
JournalInternational Journal of Pharmacy and Pharmaceutical Sciences
Volume5
Issue number2
Publication statusPublished - 2013

Fingerprint

Fibrinolytic Agents
Streptokinase
Myocardial Infarction
Tissue Plasminogen Activator
Creatine Kinase
Drug-Related Side Effects and Adverse Reactions
Uncertainty
Medical Records
Myocardium
Hypersensitivity
Hospitalization
Arteries
Hemorrhage
Costs and Cost Analysis
Survival
Therapeutics

Keywords

  • Acute myocardial infarction
  • Alteplase
  • Creatine kinase
  • Streptokinase
  • Thrombolytic agents

ASJC Scopus subject areas

  • Pharmaceutical Science
  • Pharmacology

Cite this

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title = "The use of thrombolytic agents in acute myocardial infarction (AMI) patients",
abstract = "What is known: Rapid restoration of patency of the infarct-related artery is the key to preserving myocardium and improving survival in acute myocardial infarction (AMI). Controversy surrounding the efficacy and cost of thrombolytic agents has lent uncertainty to the choice of thrombolytic agents. Objective: The primary objective of this study was to assess the use of thrombolytic agents in AMI, including time to treatment, and types, efficacy, and adverse effects of thrombolytic agents employed. Methods: Patients who were hospitalised with AMI over the past two years from January 2007 to December 2008 were involved. Medical records were retrospectively reviewed. Results: The thrombolytic agents were most commonly given within two to four hours (42.85{\%}) of symptom onset and were rarely given after 12 hours (11.43{\%}). A negative correlation was found between time to treatment and creatine kinase (CK) reduction [r(33) = -0.27, p>0.05]. The majority of the patients were given streptokinase. No significant differences were found between streptokinase and alteplase in CK reduction, duration of hospitalisation, and post-infarct residual heart function. Bleeding was the predominant adverse drug event reported in the alteplase treatment group. Streptokinase was associated with cardiovascular side effects and allergic reactions. What is New: The study included Malaysian patients. Conclusion: streptokinase and alteplase had similar efficacy in AMI patients. Other factors such as adverse effects should be considered when selecting a thrombolytic agent.",
keywords = "Acute myocardial infarction, Alteplase, Creatine kinase, Streptokinase, Thrombolytic agents",
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AU - Wei, Wong Sin

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N2 - What is known: Rapid restoration of patency of the infarct-related artery is the key to preserving myocardium and improving survival in acute myocardial infarction (AMI). Controversy surrounding the efficacy and cost of thrombolytic agents has lent uncertainty to the choice of thrombolytic agents. Objective: The primary objective of this study was to assess the use of thrombolytic agents in AMI, including time to treatment, and types, efficacy, and adverse effects of thrombolytic agents employed. Methods: Patients who were hospitalised with AMI over the past two years from January 2007 to December 2008 were involved. Medical records were retrospectively reviewed. Results: The thrombolytic agents were most commonly given within two to four hours (42.85%) of symptom onset and were rarely given after 12 hours (11.43%). A negative correlation was found between time to treatment and creatine kinase (CK) reduction [r(33) = -0.27, p>0.05]. The majority of the patients were given streptokinase. No significant differences were found between streptokinase and alteplase in CK reduction, duration of hospitalisation, and post-infarct residual heart function. Bleeding was the predominant adverse drug event reported in the alteplase treatment group. Streptokinase was associated with cardiovascular side effects and allergic reactions. What is New: The study included Malaysian patients. Conclusion: streptokinase and alteplase had similar efficacy in AMI patients. Other factors such as adverse effects should be considered when selecting a thrombolytic agent.

AB - What is known: Rapid restoration of patency of the infarct-related artery is the key to preserving myocardium and improving survival in acute myocardial infarction (AMI). Controversy surrounding the efficacy and cost of thrombolytic agents has lent uncertainty to the choice of thrombolytic agents. Objective: The primary objective of this study was to assess the use of thrombolytic agents in AMI, including time to treatment, and types, efficacy, and adverse effects of thrombolytic agents employed. Methods: Patients who were hospitalised with AMI over the past two years from January 2007 to December 2008 were involved. Medical records were retrospectively reviewed. Results: The thrombolytic agents were most commonly given within two to four hours (42.85%) of symptom onset and were rarely given after 12 hours (11.43%). A negative correlation was found between time to treatment and creatine kinase (CK) reduction [r(33) = -0.27, p>0.05]. The majority of the patients were given streptokinase. No significant differences were found between streptokinase and alteplase in CK reduction, duration of hospitalisation, and post-infarct residual heart function. Bleeding was the predominant adverse drug event reported in the alteplase treatment group. Streptokinase was associated with cardiovascular side effects and allergic reactions. What is New: The study included Malaysian patients. Conclusion: streptokinase and alteplase had similar efficacy in AMI patients. Other factors such as adverse effects should be considered when selecting a thrombolytic agent.

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