Switch to
Predicate | Object |
---|---|
rdf:type | |
lifeskim:mentions | |
pubmed:issue |
7
|
pubmed:dateCreated |
1988-9-30
|
pubmed:abstractText |
To determine the role of intravenous tissue plasminogen activator (t-PA) in unstable angina, it was compared with placebo in a randomized, double-blind trial. Forty patients with angina at rest and provocable ischemia (pacing induced) had baseline coronary angiography, study drug infusion and then repeat angiography at 20 +/- 9 hours. All patients received diltiazem, nitrates, beta blockers, aspirin and intravenous heparin. During study drug infusion (150 mg over 8 hours), refractory ischemia necessitating emergency bypass surgery (CABG) or coronary angioplasty (PTCA) occurred in 4 of 20 t-PA patients compared with 1 of 20 placebo patients (p = 0.21). Before discharge, revascularization for persistent, provocable ischemia and a residual stenosis greater than or equal to 60% was as follows: t-PA patients, 8 PTCA and 7 CABG; placebo patients, 11 PTCA and 8 CABG (p = 0.39). Quantitative angiographic percent diameter stenosis of the culprit artery at baseline and follow-up was: t-PA 71 +/- 17 and 63 +/- 22; placebo 70 +/- 19 and 67 +/- 22 (difference not significant). However, 3 t-PA patients compared with no placebo patients demonstrated an insignificant (less than 60% diameter) residual stenosis and averted PTCA (p = 0.14). There were no complications of PTCA in the 8 t-PA patients; in contrast, 3 of 11 placebo patients had abrupt closure, necessitating emergency CABG in 2 (p = 0.23). Thus, intravenous t-PA in unstable angina can eliminate the need for PTCA in a few patients, does not appear to decrease the overall or emergency rate of revascularization procedures and may facilitate the safety of PTCA.
|
pubmed:language |
eng
|
pubmed:journal | |
pubmed:citationSubset |
AIM
|
pubmed:chemical | |
pubmed:status |
MEDLINE
|
pubmed:month |
Sep
|
pubmed:issn |
0002-9149
|
pubmed:author | |
pubmed:issnType |
Print
|
pubmed:day |
1
|
pubmed:volume |
62
|
pubmed:owner |
NLM
|
pubmed:authorsComplete |
Y
|
pubmed:pagination |
368-71
|
pubmed:dateRevised |
2007-11-15
|
pubmed:meshHeading |
pubmed-meshheading:2970776-Angina, Unstable,
pubmed-meshheading:2970776-Angina Pectoris,
pubmed-meshheading:2970776-Angiography,
pubmed-meshheading:2970776-Angioplasty, Balloon,
pubmed-meshheading:2970776-Blood Transfusion,
pubmed-meshheading:2970776-Clinical Trials as Topic,
pubmed-meshheading:2970776-Coronary Angiography,
pubmed-meshheading:2970776-Coronary Artery Bypass,
pubmed-meshheading:2970776-Double-Blind Method,
pubmed-meshheading:2970776-Hemorrhage,
pubmed-meshheading:2970776-Humans,
pubmed-meshheading:2970776-Injections, Intravenous,
pubmed-meshheading:2970776-Postoperative Complications,
pubmed-meshheading:2970776-Random Allocation,
pubmed-meshheading:2970776-Tissue Plasminogen Activator
|
pubmed:year |
1988
|
pubmed:articleTitle |
Coronary revascularization after intravenous tissue plasminogen activator for unstable angina pectoris: results of a randomized, double-blind, placebo-controlled trial.
|
pubmed:affiliation |
Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor.
|
pubmed:publicationType |
Journal Article,
Clinical Trial,
Randomized Controlled Trial,
Research Support, Non-U.S. Gov't
|