Thrombolytic therapy

Injury	Disease	Nutrition	Poison

Symptoms	Surgery	Test	Special Topic

Stroke

Thrombus

Overview

Thrombolytic therapy

Definition:

Thrombolytic therapy involves the use of drugs that break up or dissolve blood clots, which are the main cause of both heart attacks and stroke. These drugs, of which tPA is the most commonly used, mimic the function of natural tissue plasminogen activator (TPA).

Alternative Names:
Tissue plasminogen activator;TPA; Alteplase; Reteplase; Tenecteplase; Activase thrombolytic agent; Clot-dissolving agents; Reperfusion therapy
Information:

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Since 1996, tPA has been approved by the Food and Drug Administration (FDA) for the treatment of stroke and heart attack. According to the American Heart Association (AHA), if tPA is given within the first 3 hours of a stroke, it may reduce permanent disability. If given within 12 hours of the onset of a heart attack, the person has a better chance for survival and recovery.

There are various drugs that dissolve clots, but tPA is currently used most often. Others include Streptokinase (SK), Reteplase, Tenecteplase, Urokinase, Lanoteplase, and Staphylokinase.

HEART ATTACK

According to the American College of Cardiology (ACC), each year 800,000 persons in the United States have acute heart attacks and 213,000 die. Those who die from heart attacks generally die within 1 hour from the initial onset of symptoms and sometimes before they get to the hospital.

Guidelines are used to determine if someone is a good candidate for using tPA. Many national groups are working together to decrease the time it takes to get people having a heart attack to facilities where tPA can be given. The sooner thrombolytic therapy is given, the better the outcome. The window of opportunity is a very short amount of time.

For a person having an acute heart attack, tPA works by dissolving a major clot quickly. The clot is most likely blocking one of the coronary arteries that normally allows blood and oxygen get to the heart muscle.

By dissolving the clot, the blood is able to start flowing again to that area of the heart. If the blood flow to the heart is started again rapidly, it may prevent long-term damage to the heart muscle and may even stop an event that could have been fatal.

The drug is successful in restoring some blood flow to the heart muscle in approximately 75% of patients, but the resultant blood flow may not be entirely normal. Further therapy, such as cardiac catheterization, may be needed.

Physicians base their decisions about whether to give tPA for a heart attack on many factors, including a history of chest pain and the results of an ECG test.