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Rationale for bolus t-PA therapy to improve efficacy and safety Agnelli GChest 1990[Apr]; 97 (4 Suppl): 161S-167STissue-type plasminogen activator has high affinity for fibrin and is activated by fibrin. Because of these properties, t-PA was initially expected to cause minimal bleeding complications. This prediction has been only partially confirmed in major clinical trials in which t-PA was given in the doses necessary for effective coronary thrombolysis. The risk of bleeding in patients receiving t-PA is correlated with increased levels of fibrin degradation products and hypofibrinogenemia, consistent with a link between systemic plasminemia and hemorrhage. Limiting t-PA-associated bleeding may therefore require measures aimed at decreasing hyperplasminemia. These measures include a short infusion of a high t-PA dose. This article presents new experimental evidence that has confirmed our previous results showing that a short infusion of t-PA is an effective and safe thrombolytic treatment.|*Thrombolytic Therapy/methods[MESH]|Animals[MESH]|Hemorrhage/chemically induced[MESH]|Infusions, Intravenous[MESH]|Injections, Intravenous[MESH]|Rabbits[MESH]|Streptokinase/administration & dosage/adverse effects/therapeutic use[MESH]|Tissue Plasminogen Activator/*administration & dosage/adverse effects/therapeutic use[MESH] |
