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Managing ST elevation myocardial infarction

F.J. Van de Werf*,1, E.M. Antman2 and M.L. Simoons3

a University Hospital Gasthuisberg, Leuven, Belgium
b Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts, USA
c Erasmus Universiteit Rotterdam, Rotterdam, The Netherlands

* Correspondence: Frans J. Van de Werf, MD, PhD, Professor and Chairman, Dienst Cardiologie, UZ Gasthuisberg, Herestraat, 49, 3000 Leuven, Belgium.

Abstract

Fibrinolytic therapy has long been an important component of the treatment of patients with ST-elevation myocardial infarction (STEMI). Several new treatment strategies are currently being developed to improve the treatment of STEMI. These strategies include the development of new fibrinolytic agents that possess longer half-lives or increased fibrin specificity as compared with streptokinase or alteplase; combining fibrinolytic therapy with recently developed antiplatelet medications; and substitution of low-molecular weight heparins or other newer thrombin inhibitors for unfractionated heparin to improve the safety, convenience and efficacy of antithrombotic therapy.

Key Words: Antiplatelet agents • fibrinolytic drugs • low-molecular-weight heparin • myocardial infarction

References

  1. Fuster V, Badimon L, Badimon JJ, Chesebro JH. The pathogenesis of coronary artery disease and the acute coronary syndromes (2). N Engl J Med. 1992;326:310–318[Web of Science][Medline]
  2. Fuster V, Badimon L, Badimon JJ, Chesebro JH. The pathogenesis of coronary artery disease and the acute coronary syndromes (1). N Engl J Med. 1992;326:242–250[Web of Science][Medline]
  3. AnonymousLancet. 1987;2:871–874[Medline]
  4. AnonymousN Engl J Med. 1993;329:673–682[Abstract/Free Full Text]
  5. AnonymousLancet. 1992;339:753–770[Web of Science][Medline]
  6. AnonymousEur Heart J. 1997;18:1371–1381[Free Full Text]
  7. Granger CB, Becker R, Tracy RP, et al. Thrombin generation, inhibition and clinical outcomes in patients with acute myocardial infarction treated with thrombolysic therapy and heparin: results from the GUSTO-I Trial. GUSTO-1 Hemostasis Substudy Group. Global Utilization of Streptokinase and TPA for Occluded Coronary Arteries. J Am Coll Cardiol. 1998;31:497–505[Abstract/Free Full Text]
  8. Hoffmeister HM, Szabo S, Kastner C, et al. Thrombolytic therapy in acute myocardial infarction: comparison of procoagulant effects of streptokinase and alteplase regimens with focus on the kallikrein system and plasmin. Circulation. 1998;98:2527–2533[Abstract/Free Full Text]
  9. Hoffmeister HM, Kastner C, Szabo S, et al. Fibrin specificity and procoagulant effect related to the kallikrein-contact phase system and to plasmin generation with double-bolus reteplase and front-loaded alteplase thrombolysis in acute myocardial infarction. Am J Cardiol. 2000;86:263–268[CrossRef][Web of Science][Medline]
  10. Gulba DC, Bode C, Runge MS, Huber K. Thrombolysic agents: an overview. Ann Hematol. 1996;73(suppl 1):S9–S27
  11. McLeod DC, Coln WG, Thayer CF, Perfetto EM, Hartzema AG. Pharmacoepidemiology of bleeding events after use of r-alteplase or streptokinase in acute myocardial infarction. Ann Pharmacother. 1993;27:956–962[Abstract]
  12. Simoons ML, Maggioni AP, Knatterud G, et al. Individual risk assessment for intracranial haemorrhage during thrombolysic therapy. Lancet. 1993;342:1523–1528[CrossRef][Web of Science][Medline]
  13. Berkowitz SD, Granger CB, Pieper KS, et al. Incidence and predictors of bleeding after contemporary thrombolysic therapy for myocardial infarction. The Global Utilization of Streptokinase and Tissue Plasminogen activator for Occluded coronary arteries (GUSTO) I Investigators. Circulation. 1997;95:2508–2516[Abstract/Free Full Text]
  14. AnonymousLancet. 1999;354:716–722[CrossRef][Web of Science][Medline]
  15. Colucci M, Cavallo LG, Agnelli G, et al. Properties of chimeric (tissue-type/urokinase-type) plasminogen activators obtained by fusion at the plasmin cleavage site. Thromb Haemost. 1993;69:466–472[Medline]
  16. Coller BS. The role of platelets in arterial thrombosis and the rationale for blockade of platelet GPIIb/IIIa receptors as antithrombotic therapy. Eur Heart J. 1995;16(suppl L):11–15
  17. Vorchheimer DA, Badimon JJ, Fuster V. Platelet glycoprotein IIb/IIIa receptor antagonists in cardiovascular disease. JAMA. 1999;281:1407–1414[Abstract/Free Full Text]
  18. Antman EM, Giugliano RP, Gibson CM, et al. Abciximab facilitates the rate and extent of thrombolysis: results of the thrombolysis in myocardial infarction (TIMI) 14 trial. The TIMI 14 Investigators. Circulation. 1999;99:2720–2732[Abstract/Free Full Text]
  19. Herrmann HC, Moliterno DJ, Ohman EM, et al. Facilitation of early percutaneous coronary intervention after reteplase with or without abciximab in acute myocardial infarction: results from the SPEED (GUSTO-4 Pilot) Trial. J Am Coll Cardiol. 2000;36:1489–1496[Abstract/Free Full Text]
  20. Topol EJ. 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;357:1905–1914[CrossRef][Web of Science][Medline]
  21. Lancet. 2001;358:605–613[CrossRef][Web of Science][Medline]
  22. Granger CB, Hirsch J, Califf RM, et al. Activated partial thromboplastin time and outcome after thrombolysic therapy for acute myocardial infarction: results from the GUSTO-I trial. Circulation. 1996;93:870–875[Abstract/Free Full Text]
  23. Braunwald E, Antman EM, Beasley JW, et al. ACC/AHA guidelines for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction: executive summary and recommendations: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients With Unstable Angina). J Am Coll Cardiol. 2000;36:970–1062[Free Full Text]
  24. AnonymousLancet. 1990;336:65–71[Web of Science][Medline]
  25. Bertrand ME, Simoons ML, Fox KA, et al. Management of acute coronary syndromes: acute coronary syndromes without persistent ST segment elevation; recommendations of the Task Force of the European Society of Cardiology. Eur Heart J. 2000;21:1406–1432[Free Full Text]
  26. Wallentin L. Low molecular weight heparin in unstable coronary artery disease. Expert Opin Investig Drugs. 2000;9:581–592[CrossRef][Web of Science][Medline]
  27. Antman EM, McCabe CH, Gurfinkel EP, et al. Enoxaparin prevents death and cardiac ischemic events in unstable angina/non-Q-wave myocardial infarction. Results of the thrombolysis in myocardial infarction (TIMI) 11B trial. Circulation. 1999;100:1593–1601[Abstract/Free Full Text]
  28. Cohen M, Demers C, Gurfinkel EP, et al. A comparison of low-molecular-weight heparin with unfractionated heparin for unstable coronary artery disease. Efficacy and Safety of Subcutaneous Enoxaparin in Non-Q-Wave Coronary Events Study Group. N Engl J Med. 1997;337:447–452[Abstract/Free Full Text]
  29. Goodman SG, Cohen M, Bigonzi F, et al. Randomized trial of low molecular weight heparin (enoxaparin) versus unfractionated heparin for unstable coronary artery disease: one-year results of the ESSENCE Study. Efficacy and Safety of Subcutaneous Enoxaparin in Non-Q Wave Coronary Events. J Am Coll Cardiol. 2000;36:693–698[Abstract/Free Full Text]
  30. Glick A, Kornowski R, Michowich Y, et al. Reduction of reinfarction and angina with use of low-molecular-weight heparin therapy after streptokinase (and heparin) in acute myocardial infarction. Am J Cardiol. 1996;77:1145–1148[CrossRef][Web of Science][Medline]
  31. Chamuleau SA, de Winter RJ, Levi M, et al. Low molecular weight heparin as an adjunct to thrombolysis for acute myocardial infarction: the FATIMA study. Fraxiparin Anticoagulant Therapy in Myocardial Infarction Study Amsterdam (FATIMA) Study Group. Heart. 1998;80:35–39[Abstract/Free Full Text]
  32. Frostfeldt G, Ahlberg G, Gustafsson G, et al. Low molecular weight heparin (dalteparin) as adjuvant treatment of thrombolysis in acute myocardial infarction: a pilot study: biochemical markers in acute coronary syndromes (BIOMACS II). J Am Coll Cardiol. 1999;33:627–633[Abstract/Free Full Text]
  33. Ross AM, Molhoek P, Lundergan C, et al. Randomized comparison of enoxaparin, a low-molecular-weight heparin, with unfractionated heparin adjunctive to recombinant tissue plasminogen activator thrombolysis and aspirin: second trial of Heparin and Aspirin Reperfusion Therapy (HART II). Circulation. 2001;104:648–652[Abstract/Free Full Text]
  34. Simoons ML, Krzeminska-Pakula M, Alonso A, et al. Improved reperfusion and clinical outcomes with enoxaparin as an adjunct to streptokinase thrombolysis in acute myocardial infarction. Eur Heart J. 2002;: in press
  35. Wallentin L, Dellborg DM, Lindahl B, Nilsson T, Pehrsson K, Swahn E. The low-molecular-weight heparin dalteparin as adjuvant therapy in acute myocardial infarction: the ASSENT PLUS study. Clin Cardiol. 2001;24:I12–114[Web of Science][Medline]
  36. Turpie AG, Gallus AS, Hoek JA. A synthetic pentasaccharide for the prevention of deep-vein thrombosis after total hip replacement. N Engl J Med. 2001;344:619–625[Abstract/Free Full Text]
  37. Coussement PK, Bassand JP, Convens C, et al. A synthetic factor-Xa inhibitor (ORG31540SR9017A) as an adjunct to fibrinolysis in acute myocardial infarction. The PENTALYSE study. Eur Heart J. 2001;22:1716–1724[Abstract/Free Full Text]
  38. Bates SM, Weitz JI. Direct thrombin inhibitors for treatment of arterial thrombosis: potential differences between bivalirudin and hirudin. Am J Cardiol. 1998;82:12P–18P[CrossRef][Web of Science][Medline]
  39. AnonymousN Engl J Med. 1996;335:775–782[Abstract/Free Full Text]
  40. Antman EM. Hirudin in acute myocardial infarction. Safety report from the Thrombolysis and Thrombin Inhibition in Myocardial Infarction (TIMI) 9A Trial. Circulation. 1994;90:1624–1630[Abstract/Free Full Text]
  41. AnonymousCirculation. 1994;90:1631–1637[Abstract/Free Full Text]

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