Thrombolysis with recombinant unglycosylated single-chain urokinase-type plasminogen activator (saruplase) in acute myocardial infarction: influence of heparin on early patency rate (LIMITS study)

Tebbe, Ulrich; Windeler, Jürgen; Boesl, Irmgard; Hoffmann, H; Wójcik, Jarosław; Ashmawy, Medhat Mohamed; Schwarz, Ernst Rüdiger; Loewis, Patric von; Rosemeyer, Peter; Hopkins, Gwyn; Barth, H.

doi:10.1016/0735-1097(95)80008-5

Cited by 38 publications

(13 citation statements)

References 30 publications

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“…After review of abstracts, an additional 16 studies were excluded. [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] After review of the full article, an additional 8 studies were excluded because they were not properly randomized (nϭ3) [33][34][35] ; because at least 1 randomized treatment group did not receive aspirin (nϭ3) 36 -38 ; or because they were preliminary reports or the results of a substudy with the main results having been reported elsewhere (nϭ2). 39,40 Clinical outcome data could not be obtained for 1 additional study, 41 leaving 14 randomized trials, involving a combined total of 25 280 patients, for inclusion in the meta-analysis (Tables 1 to 3).…”

Section: Study Selectionmentioning

confidence: 99%

Unfractionated and Low-Molecular-Weight Heparin as Adjuncts to Thrombolysis in Aspirin-Treated Patients With ST-Elevation Acute Myocardial Infarction

et al. 2005

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Section: Study Selectionmentioning

confidence: 99%

Unfractionated and Low-Molecular-Weight Heparin as Adjuncts to Thrombolysis in Aspirin-Treated Patients With ST-Elevation Acute Myocardial Infarction

et al. 2005

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“…22 The thrombolytic effect is enhanced by heparin, possibly through neutralization of thrombin or by stimulating tPA from the endothelium. 23,24 Prourokinase was utilized for IA thrombolysis studies in the mid-1990s. The Prolyse in Acute Cerebral Thromboembolism (PROACT) trial evaluated IA infusion of prourokinase (6 mg) vs placebo for treatment of middle cerebral artery (MCA) occlusion in patients who presented within 6 hours of symptom onset.…”

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confidence: 99%

Advances in thrombolytics for treatment of acute ischemic stroke

Kirmani¹,

Alkawi²,

Panezai³

et al. 2012

Neurology

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Over the past 50 years, thrombolytic agents have been devised with the aim of recanalizing occluded coronary vessels, and later on, applied in the setting of acute ischemic stroke. Pharmacologic agents have generally targeted the plasminogen-plasmin transformation, facilitating the natural process of fibrinolysis. Newer agents with varying degrees of fibrin selectivity and pharmacologic half-life have influenced both recanalization rates and hemorrhagic complications, inside and outside the CNS. Intra-arterial (IA) administration of fibrinolytic agents increases delivery of the drug to the thrombus at a higher concentration with smaller quantities and therefore lowers systemic exposure. Mechanical thrombus disruption or extraction allows for drug delivery to a greater surface area of the thrombus. Delays associated with IA therapy may worsen the risk/ benefit ratio of thrombolysis; therefore, combinations of IA-IV treatments have been studied. To date, there are no direct comparative trials to show that endovascular administration is more efficacious or carries a lower risk of hemorrhagic complications than IV tissue plasminogen activator. Neurology ® 2012;79 (Suppl 1):S119-S125

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“…heparin. The thrombolytic effect of r-proUK is increased by heparin, possibly through thrombin neutralization or by stimulating tPA release from the endothelium [20,21]. Heparin strongly influenced both recanalization and intracerebral hemorrhage: high rates of partial or complete recanalization were achieved with r-proUK treatment (particularly in those patients receiving higher doses of heparin), although with a higher but not significant rate of intracerebral hemorrhages (15% vs. 7%).…”

Section: Intraarterial Thrombolysismentioning

confidence: 98%

The Role of Thrombolysis in Acute Ischemic Stroke

Orso

Baldasseroni

Maggioni

2008

Herz

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Up to the mid-1990 s, the treatment of acute ischemic stroke was almost anecdotal. The introduction of systemic thrombolysis dramatically changed the scenario improving patient outcomes and becoming the standard of care for patients who present within 3 h from the onset of symptoms. Other options, such as intraarterial thrombolysis, or different mechanical reperfusion approaches, have been tested in the past few years. The benefit-risk profile of these approaches is discussed in this review. The current main challenge in the therapy of acute stroke is to define the optimal strategy for patients excluded from thrombolysis because of delayed presentation or older age and for patients treated with thrombolysis that do not reperfuse.

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Thrombolysis with recombinant unglycosylated single-chain urokinase-type plasminogen activator (saruplase) in acute myocardial infarction: influence of heparin on early patency rate (LIMITS study)

Abstract: In acute myocardial infarction, the administration of a heparin bolus before thrombolytic therapy with saruplase is associated with a significantly higher patency at angiography 6 to 12 h after the start of thrombolysis without any appreciable increase in risk of bleeding.

Cited by 38 publications

References 30 publications

Unfractionated and Low-Molecular-Weight Heparin as Adjuncts to Thrombolysis in Aspirin-Treated Patients With ST-Elevation Acute Myocardial Infarction

Unfractionated and Low-Molecular-Weight Heparin as Adjuncts to Thrombolysis in Aspirin-Treated Patients With ST-Elevation Acute Myocardial Infarction

Advances in thrombolytics for treatment of acute ischemic stroke

The Role of Thrombolysis in Acute Ischemic Stroke

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