Biomedical subjects

D Collen

Publications and source records attributed to D Collen.

At least 487 records · Page 27Linked to original sources

PubMed1987

Thrombolytic therapy for unstable angina pectoris: rationale and results.

The coronary lesion in unstable angina consists of disrupted atherosclerotic plaque with nonocclusive intraluminal thrombus, which frequently persists despite heparin anticoagulation. A 12 hour infusion of recombinant tissue-type plasminogen activator combined with heparin effectively lyses the thrombus and stabilizes the clinical syndrome but is associated with a high incidence of bleeding. Therapeutic schemes of thrombolytic therapy associated with a lower bleeding frequency may be useful for the treatment of unstable angina.

Angina Pectoris↗

PubMed1987

A multicenter, randomized, placebo-controlled trial of a new form of intravenous recombinant tissue-type plasminogen activator (activase) in acute myocardial infarction.

A new, predominantly single chain preparation of recombinant tissue-type plasminogen activator was evaluated to determine coronary thrombolytic efficacy in 100 patients with acute myocardial infarction. At 3.6 +/- 1.2 hours (mean +/- SD) from symptom onset, patients received either intravenous tissue plasminogen activator (1.25 mg/kg body weight over 3 hours) or placebo on a 3:1 randomized, double-blind basis. Coronary angiography, performed 68 +/- 13 minutes after initiation of the study drug infusion, demonstrated patency of the infarct-related artery in 40 (57%) of 70 patients in the tissue plasminogen activator group compared with 3 (13%) of 23 patients in the placebo group (p less than 0.001). Patients in the placebo group were then eligible to receive intracoronary streptokinase. At 90 minutes the patency was observed in 49 (69%) of 71 tissue plasminogen activator patients compared with 5 (24%) of 21 placebo patients (p less than 0.001). At 120 minutes patency was observed in 59 (79%) of 75 patients of the tissue plasminogen activator group and in 10 (40%) of 25 in the intracoronary streptokinase/placebo group. A nadir value of less than 100 mg/dl fibrinogen occurred in 8 (11%) of 73 patients receiving tissue plasminogen activator versus 8 (40%) of 20 patients treated with intracoronary streptokinase (p = 0.002). Moderate or severe bleeding episodes occurred in 39% of patients treated with tissue plasminogen activator compared with 32% of patients who received placebo/intracoronary streptokinase (p = NS). Thus, this tissue plasminogen activator preparation achieves a high rate of recanalization and, at the doses employed, exhibits increased fibrinogen sparing compared with intracoronary streptokinase.

Angiography↗

PubMed1987

Treatment of prosthetic tricuspid valve thrombosis with recombinant tissue-type plasminogen activator.

Recombinant tissue-type plasminogen activator (rt-PA) was administered intravenously to a 64-years old female with thrombotic malfunction of a Björk-Shiley prosthetic tricuspid valve. 150 mg of single-chain rt-PA was infused over 8 hours followed by an additional dose of 50 mg over the next 8 hours. At the end of the first infusion, restoration of normal valve function was demonstrated by fluoroscopic and echo-Doppler examinations. Mild systemic activation of the fibrinolytic system occurred, with a decrease of fibrinogen and alpha 2-antiplasmin to 53% and 33%, respectively, of the preinfusion value at the nadir.

Female↗

PubMed1987

Reduction in infarct size and enhanced recovery of systolic function after coronary thrombolysis with tissue-type plasminogen activator combined with beta-adrenergic blockade with metoprolol.

The effect of beta-adrenergic blockade on the salvage and functional recovery of reperfused myocardium was investigated in anesthetized dogs. Immediately after thrombotic occlusion of the left anterior descending coronary artery, the cardioselective beta-blocking agent metoprolol was given intravenously at a dose of 0.5 mg/kg infused over 10 min. One hour after the onset of occlusion, recanalization was initiated by intravenous infusion of recombinant human tissue-type plasminogen activator (rt-PA, 10 micrograms/kg/min for 30 min). Anatomic infarct size expressed as percent of the left ventricular mass (I/LV), global ejection fraction, and mean systolic shortening of the segmental radii (SS) of the infarcted area were measured either after 24 hr or 1 week in six groups of six dogs each: group I (rt-PA + metoprolol, evaluated at 24 hr), group II (rt-PA + metoprolol, evaluated at 1 week, group III (rt-PA alone, evaluated at 24 hr), group IV (rt-PA alone, evaluated at 1 week), group V (persistent occlusion, evaluated at 24 hr), and group VI (persistent occlusion, evaluated at 1 week). The smallest infarcts were found in reperfused dogs given metoprolol, but the differences from dogs receiving rt-PA alone were not statistically significant (I/LV, expressed as mean +/- SEM: 5.5 +/- 0.9% in group I, 6.7 +/- 1.9% in group II, 15.4 +/- 5.0% in group III, 11.4 +/- 3.5% in group IV, 23.6 +/- 2.5% in group V, and 26.9 +/- 2.3% in group VI).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1987

A randomized, blinded, placebo-controlled trial of recombinant human tissue-type plasminogen activator in patients with unstable angina pectoris.

Twenty-four patients with unstable angina pectoris, defined as chest pain at rest with transient ST segment deviation of at least 1 mm, were randomly assigned to blinded treatment with either placebo or intravenous recombinant human tissue-type plasminogen activator (rt-PA). Before randomization, all patients were treated with oral beta-blockers, calcium antagonists, nitrates, and continuous intravenous heparin for a monitoring period of 12 to 28 hr. After this monitoring period the 24 patients were randomly assigned to receive either placebo or 1.75 mg/kg intravenous rt-PA given over 12 hr at a rate of 0.75 mg/kg over 1 hr, 0.5 mg/kg over 4 hr, and 0.5 mg/kg over 7 hr. One patient, assigned to receive placebo, developed acute myocardial infarction after randomization but before receiving the study drug. Ischemic events were recorded during a hospital follow-up period of at least 4 days unless a further intervention was indicated or the coronary angiogram was normal. The follow-up period was 7 +/- 5 days (mean +/- SD) after the placebo infusion and 8 +/- 4 days after the infusion of rt-PA. Unstable angina pectoris persisted after the completion of the infusion in six of 11 patients receiving placebo and only one of 12 patients receiving rt-PA (p less than .03). Coronary angiography, performed 38 +/- 19 hr after the infusion, demonstrated subocclusive thrombus in eight of 11 patients receiving placebo but in none of 11 patients treated with rt-PA (p less than .002). One patient on rt-PA refused coronary angiography.(ABSTRACT TRUNCATED AT 250 WORDS)

Angina Pectoris↗

PubMed1987

Measurement of free, one-chain tissue-type plasminogen activator in human plasma with an enzyme-linked immunosorbent assay based on an active site-specific murine monoclonal antibody.

An enzyme-linked immunosorbent assay for free tissue-type plasminogen activator (t-PA) in human blood was developed based on a murine monoclonal antibody directed against the active site of t-PA. The lower limit of sensitivity of the assay applied to plasma is 2 ng/mL for one-chain t-PA but only 100 ng/mL for two-chain t-PA. Free t-PA in plasma taken at rest was found in 6 of 21 healthy subjects (4.5 +/- 0.8 ng/mL, mean +/- SD) and increased to 14 +/- 7.0 ng/mL after venous occlusion in 18 of these individuals. A linear correlation between total t-PA and free t-PA was observed with r = 0.92 (n = 18) and a slope of 1.08, indicating that t-PA released from the vessel wall circulates in the blood as the one-chain form. In 16 of 18 patients with deep vein thrombosis, the increase of total t-PA antigen after venous occlusion was comparable to that observed in controls, but the free t-PA was significantly lower or undetectable. The present assay for free t-PA may be useful for the investigation of the release and inhibition of t-PA under physiological, pharmacological, or pathological conditions in humans.

Antibodies, Monoclonal↗

PubMed1987

Thrombolysis with recombinant human single-chain urokinase-type plasminogen activator (rscu-PA): dose-response in dogs with coronary artery thrombosis.

The dose-response of an intravenous i.v. infusion for 30 min of recombinant human single-chain urokinase-type plasminogen activator (rscu-PA) was investigated in dogs with 1-h-old clots in the left anterior descending coronary artery. The clots were induced with a copper coil, and thrombolysis was monitored by repeated coronary angiography. Intravenous infusion of rscu-PA at a rate of 2 micrograms/kg/min did not induce lysis within 30 min (n = 4). Infusion at a rate of 4 micrograms/kg/min in 7 dogs produced complete lysis in 2 (within 25 and 27 min), partial lysis in 2 (within 18 and 25 min), and no lysis in 3. Infusion at 8 micrograms/kg/min in four dogs caused complete lysis in three dogs within 18 +/- 3 min (mean +/- SD) and partial lysis in the fourth animal. Infusion at 20 micrograms/kg/min in four dogs induced complete lysis within 14 +/- 3 min. A linear correlation was observed between the infusion rate and the plateau level of rscu-PA in blood. At the highest infusion rate (20 micrograms/kg/min), the concentration of rscu-PA in blood was 2.5 +/- 0.45 microgram/ml, but this was not associated with systemic fibrinolytic activation because the alpha 2-antiplasmin and fibrinogen levels remained essentially unchanged. It is concluded that i.v. infusion of recombinant single-chain urokinase-type plasminogen activator (rscu-PA) at a sufficiently high rate (greater than or equal to 8 micrograms/kg/min) produces coronary thrombolysis without systemic fibrinolysis in dogs.

Animals↗

PubMed1987

[Low molecular weight heparin CY 222 (Choay) potentiates the thrombolytic effect of 1-PA in rabbits with experimental thrombosis of the jugular vein].

The effect of a low molecular weight heparin CY 222 (Choay) on t-PA induced thrombolysis was investigated in the rabbit jugular thrombosis model. The compound CY 222 was administered as 1.4 mg/kg (group A) by IV injection immediately after start of t-PA infusion (0.125 and 0.250 mg/kg) and then hourly during the 4 hours of infusion of the thrombolytic; results were compared with those obtained in the absence of CY 222 (group B). A significant increase in percent thrombolysis was noted in the presence of CY 222: A versus B = 31 +/- 1/22 +/- 2 (p less than 0.02) (tPA = 0.125 mg/kg; 72 +/- 4/36 +/- 3 (p less than 0.01) (tPA = 0.250 mg/kg). Anti-Xa activity 60 minutes after 1.2 u/ml IV of CY 222 was comparable with that observed in patients with venous thrombosis treated with high-dose CY 222. The conclusion is reached of the interest of CY 222 in combination with t-PA, the CY 222 acting not only on coagulation by also on thrombolysis by potentiating the effect of t-PA.

Animals↗

PubMed1987

Tissue-type plasminogen activator.

Tissue-type plasminogen activator (t-PA) is a serine protease with a molecular weight of about 70,000. It activates plasminogen to plasmin by cleavage of the Arg 560-Val 561 peptide bond. Kinetic analysis showed that the activation obeys Michaelis-Menten kinetics and that the presence of fibrin strikingly enhances the activation rate. The directed action of plasmin towards fibrin in vivo can be explained by the low Michaelis constant in the presence of fibrin (0.16 microM) which allows efficient plasminogen activation on a fibrin clot, while its high value in the absence of fibrin (65 microM) prevents efficient activation in plasma. Plasmin formed on the fibrin surface is protected from rapid inactivation by alpha 2-antiplasmin. Studies on the thrombolytic properties of t-PA (purified from melanoma cell cultures or obtained by recombinant DNA technology) in various animal models and in selected patients revealed that t-PA is a specific thrombolytic agent which induces thrombolysis without causing extensive systemic activation of the fibrinolytic system.

Animals↗

PubMed1987

Secretion of tissue-type plasminogen activator and plasminogen activator inhibitor by cultured human endothelial cells: modulation by thrombin, endotoxin, and histamine.

Primary cultures of pooled endothelial cells obtained from four to six human umbilical cord veins were grown to confluency in M 199 cell culture medium containing 20% human serum. The secretion of tissue-type plasminogen activator antigen (t-PA Ag) and fast-acting plasminogen activator inhibitor activity (PA-I activity) was measured in the conditioned medium after incubation of confluent cultures with serum-free medium for 24 hours (1.5 ml/25 cm2 cell surface). The baseline production of t-PA Ag was 2.7 +/- 1.4 ng/ml (mean +/- SD) and of PA-I activity 36 +/- 18 IU/ml. Stimulation with thrombin resulted in a dose-dependent and time-dependent increase of the secretion of both components. At 1 NIH U thrombin per milliliter, a fourfold increase of t-PA Ag and a twofold increase of PA-I activity were observed. This effect was dependent on a free active site in thrombin and specific protein synthesis (inhibited by cycloheximide and dactinomycin) but unrelated to prostacyclin synthesis (no effect of aspirin or indomethacin). No free t-PA activity could be demonstrated on fibrin plates in conditioned medium from either stimulated or nonstimulated endothelial cell cultures. Endotoxin stimulation resulted in a specific secretion of PA-I activity but not of t-PA Ag, whereas histamine stimulation at concentrations of 0.1 to 1 mumol/L caused a specific secretion of t-PA Ag but not of PA-I. These findings indicate that the secretion of t-PA Ag and PA-I activity are not necessarily coupled.(ABSTRACT TRUNCATED AT 250 WORDS)

Cells, Cultured↗

PubMed1987

Comparative thrombolytic properties of single-chain forms of urokinase-type plasminogen activator.

The specific thrombolytic properties of urokinase and three molecular forms of single-chain urokinase-type plasminogen activator (scu-PA) were compared in a human plasma milieu in vitro and in an experimental thrombosis model in rabbits. These scu-PA molecules included Mr 54,000 scu-PA from human urine (urinary scu-PA), scu-PA from conditioned media of a human lung adenocarcinoma cell line (CALU-3,ATCC,HTB-55) (cellular scu-PA) and an Mr 32,000 proteolytic derivative of cellular scu-PA (scu-PA-32k). All four molecular forms induced significant lysis of a 125I-labeled human plasma clot immersed in citrated human plasma at concentrations between 50 and 200 IU/mL. None of the four showed absolute fibrin-specificity, but at equivalent lytic dose the three single-chain forms appeared to cause less fibrinogen degradation and alpha 2-antiplasmin consumption than two-chain urokinase. In addition, the fibrinolytic potential of the three single-chain forms was largely maintained during pre-incubation in plasma for up to 48 hours whereas that of urokinase was completely inhibited. Intravenous (IV) infusion of cellular scu-PA or scu-PA-32k into rabbits with a 125I-labeled thrombus in the jugular vein caused significant dose-dependent lysis at concentrations ranging from 8,700 to 35,000 and from 9,000 to 36,000 IU/kg respectively. Clot lysis was accompanied by minor alpha 2-antiplasmin consumption or fibrinogen breakdown. In contrast, urokinase induced lysis at doses between 20,000 and 200,000 IU/kg, but at higher doses was associated with significant systemic activation of the fibrinolytic system. It is concluded that scu-PA obtained from CALU-3 cell cultures has identical thrombolytic properties to that obtained from urine. In addition, the scu-PA-32k proteolytic derivative has the same fibrin-specific thrombolytic properties as the intact molecule. Cellular scu-PA and scu-PA-32k may therefore constitute more readily available alternatives for clot-selective thrombolytic therapy in man.

Animals↗

PubMed1987

Activation of the fibrinolytic system.

The fibrinolytic system is activated either directly or indirectly by proteins that convert plasminogen to plasmin in the circulation, within the interstitices, and on the surface of fibrin clots, or both. Agents that activate circulating and clot-bound plasminogen comparably induce a systemic lytic state accompanying clot lysis. Agents that activate plasminogen in the domain of fibrin preferentially exhibit clot selectivity. Fibrinolytic activators are assayed by detection of protein, generally immunologically, or of functional activity, generally by visualization of lysis of fibrin or by spectrophotometric determination of amidolytic activity.

Acylation↗

PubMed1987

Pharmacokinetics of single chain forms of urokinase-type plasminogen activator.

The pharmacokinetics of single chain urokinase-type plasminogen activator (scu-PA) were studied in rabbits and squirrel monkeys using three of its molecular forms, Mr 54,000 isolated from human urine (urinary scu-PA), Mr 54,000 isolated from conditioned media of cultured human lung adenocarcinoma cells (CALU-3) (cellular scu-PA) and its Mr 32,000 proteolytic derivative lacking the NH2-terminal 143 amino acids (scu-PA-32k). After bolus i.v. injection in rabbits with 2.5 kg. b.wt., the disappearance rate of all three forms from plasma could be described by a two-compartment disposition model with the following pharmacokinetic parameters: alpha T1/2, 3.2 to 3.9 min; beta T1/2, 15 to 16 min; volume of the central compartment, 170 to 200 ml; total volume of distribution, 660 to 910 ml; and plasma clearance, 18 to 22 ml/min. Similar results were obtained with cellular scu-PA in squirrel monkeys. Plasma euglobulin fibrinolytic activity disappeared in parallel with antigen, suggesting that the primary mechanism of disappearance is via clearance of the intact molecule. The organ distribution of isotope after bolus injection of 125I-labeled scu-PA revealed that clearance occurred via the liver and kidneys in rabbits, but predominantly via the liver in squirrel monkeys. Functional hepatectomy prolonged the alpha T1/2 of scu-PA in rabbits, whereas nephrectomy had no significant effect. Steady-state plasma levels of scu-PA during continuous i.v. infusion were proportional to the dose given, whereas the initial postinfusion disappearance rate of scu-PA from plasma was comparable to that after bolus injection (T1/2 of 5 to 6 min).(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗

PubMed1986

Purification and characterization of a novel low molecular weight form of single-chain urokinase-type plasminogen activator.

A low Mr form (Mr 32,000) of single-chain urokinase-type plasminogen activator (scu-PA) was isolated from conditioned culture medium of a human lung adenocarcinoma cell line, CALU-3 (ATCC, HTB-55). The purified material (scu-PA-32k) consists of a single polypeptide chain and is immunologically similar to Mr 33,000 urokinase. Its NH2-terminal sequence is identical to that beginning at Leu-144 of Mr 54,000 urokinase. Whereas low Mr urokinase is derived from mature Mr 54,000 scu-PA by limited hydrolysis by plasmin first of the Lys-158-Ile-159 peptide bond and then of the Lys-136-Lys-137, scu-PA-32k is generated by specific hydrolysis of the Glu-143-Leu-144 peptide bond by an unidentified protease. scu-PA-32k resembles its Mr 54,000 scu-PA counterpart by its very low activity on chromogenic substrates for urokinase, by plasminogen-dependent fibrinolytic activity on fibrin plates, and by the lack of specific binding to fibrin. It activates plasminogen directly with high affinity, Km = 0.9 microM, but low turnover number, kcat = 0.0028 s-1. It is converted to fully active two-chain urokinase by plasmin with Km = 12 microM and kcat = 0.3 s-1. Like Mr 54,000 scu-PA, it causes significant lysis of a 125I-labeled fibrin clot in human plasma with relatively less fibrinogen breakdown as compared to urokinase. scu-PA-32k, which also has conserved fibrin specificity, represents a molecular variant which may be more suitable for large scale production as a fibrin-specific thrombolytic agent by recombinant DNA technology.

Adenocarcinoma↗

PubMed1986

Measurement of urokinase-type plasminogen activator (u-PA) with an enzyme-linked immunosorbent assay (ELISA) based on three murine monoclonal antibodies.

An enzyme-linked immunosorbent assay (ELISA) for the measurement of urokinase-type plasminogen activator (u-PA) was developed. Three murine monoclonal antibodies to single chain urokinase-type plasminogen activator (scu-PA) were isolated and shown to react with non-overlapping epitopes in scu-PA. Two of the three antibodies were coated onto microtiter plates and bound u-PA was quantitated with the third antibody conjugated to horseradish peroxidase. The assay was equally sensitive to Mr 54,000 u-PA in the single chain or two-chain form but did not respond to Mr 33,000 urokinase. The lower limit of sensitivity of the assay was 0.1 ng/ml in buffer and 1 ng/ml in plasma. Coefficients of variation of the assay at physiological levels of u-PA were 6.5 percent within assays and 13 percent between assays. The level of u-PA in normal resting plasma was 1.9 +/- 0.66 ng/ml (mean +/- SD, n = 54). The assay can be performed within one working day and provides an efficient, reproducible, and stable means for the measurement of u-PA in biological fluids. As such it may facilitate physiological and pharmacological studies of urokinase-type plasminogen activators in man.

Adult↗

PubMed1986

Comparative kinetic analysis of the activation of human plasminogen by natural and recombinant single-chain urokinase-type plasminogen activator.

Single-chain urokinase-type plasminogen activator (scu-PA) may be obtained from conditioned cell culture media (natural scu-PA) or by expression of the cDNA encoding human scu-PA in Escherichia coli (recombinant scu-PA). The activation of Glu-plasminogen by natural and recombinant scu-PA can be described by a sequence of three reactions, each of which obeys Michaelis-Menten kinetics. Initial activation of plasminogen to plasmin by scu-PA (reaction I) occurs with a high affinity (Km below 0.8 microM) for both scu-PAs, while the catalytic rate constant (k2) is 0.017 s-1 for recombinant scu-PA but only 0.0009 s-1 for natural scu-PA. Subsequent conversion of scu-PA to urokinase (two-chain urokinase-type plasminogen activator, tcu-PA) by generated plasmin (reaction II) occurs with a comparable affinity (Km about 5 microM) for natural and recombinant scu-PA and with a k2 of 0.23 s-1 for natural and 1.2 s-1 for recombinant scu-PA. Finally, activation of plasminogen by tcu-PA (reaction III) occurs with low affinity (Km 30-50 microM) but with a high catalytic rate constant (k2 about 5 s-1) for both natural and recombinant tcu-PA. The differences in the kinetic parameters of the activation of plasminogen by natural or recombinant scu-PA are thus mainly due to differences in turnover rate in the first reaction. Indeed, the catalytic rate constant of the first reaction is about 20-times higher for recombinant scu-PA than for natural scu-PA. Thus, surprisingly, the artificial, unglycosylated recombinant scu-PA molecule has a better catalytic efficiency than its natural glycosylated counterpart.

Enzyme Activation↗

PubMed1986

An enzyme-linked immunosorbent assay (ELISA) for the measurement of plasmin-alpha 2-antiplasmin complex in human plasma--application to the detection of in vivo activation of the fibrinolytic system.

An enzyme-linked immunosorbent assay (ELISA) is developed for the measurement of plasmin-alpha 2-antiplasmin complex in human plasma. Microtiter plates were coated with a mixture of two murine monoclonal antibodies directed against human alpha 2-antiplasmin and bound plasmin-alpha 2-antiplasmin complex was quantitated with a peroxidase-conjugated monoclonal antibody directed against human plasminogen. The lower limit of sensitivity of the assay was 0.01 nM of plasmin-alpha 2-antiplasmin complex in 100-fold diluted human plasma, allowing detection of 1 nM in undiluted plasma samples. After 100-fold dilution of the plasma samples, the assay was no longer influenced by the presence of the precursors plasminogen and alpha 2-antiplasmin. At a concentration of 2.0 nM of plasmin-alpha 2-antiplasmin complex in plasma, intra- and interassay variation coefficients were 4.2 and 5.5 percent respectively. In plasma samples of 25 control subjects the levels of plasmin-alpha 2-antiplasmin complex were below 1 nM. Extensive in vivo activation of the fibrinolytic system during thrombolytic therapy with streptokinase resulted in the generation of elevated levels of plasmin-alpha 2-antiplasmin complex up to 690 +/- 150 nM. No measurable levels of plasmin-alpha 2-antiplasmin complex were found in the plasma of 32 patients with acute deep vein thrombosis nor in the plasma of 11 patients with recurrent deep vein thrombosis. These findings indicate that plasmin-alpha 2-antiplasmin complex is generated during in vivo activation of the fibrinolytic system and that its assay may be useful to monitor thrombolytic therapy but not for the diagnosis of venous thrombosis.

Animals↗

PubMed1986

Dose-dependent thrombolysis, pharmacokinetics and hemostatic effects of recombinant human tissue-type plasminogen activator for coronary thrombosis.

The pharmacokinetics, thrombolytic profile and effects on hemostasis of graded intravenous doses of recombinant human tissue-type plasminogen activator (rt-PA) were studied in 45 patients with acute myocardial infarction. Infusion of rt-PA at a rate of 4 to 8.3 micrograms/kg/min resulted in plateau levels of the drug in plasma of 0.52 to 1.4 micrograms/ml. A linear relation between infusion rate and plasma rt-PA concentration was observed, although plasma drug levels varied substantially among subjects who received infusions at the same rate. The ratio between plateau levels of rt-PA in plasma and infusion rate was inversely related to initial distribution volume (7.3 +/- 2.9 liters, n = 21). The decline in plasma concentration of rt-PA, x(t), as a function of time after cessation of the infusion, was described adequately by the biexponential equation: x(t) = 0.71exp(-0.13t) + 0.29exp(-0.015t). The initial and terminal half-lives of rt-PA in the blood were 5.3 +/- 1.7 and 46.2 +/- 14 minutes, respectively. The efficacy of rt-PA for coronary thrombolysis was dose-dependent. With 4 micrograms/kg/min of rt-PA for 90 minutes, no reperfusion was achieved, whereas infusion rates of 5 micrograms/kg/min or more for 90 minutes accomplished reperfusion in more than 80% of the patients. However, the frequency of occurrence of residual intraluminal thrombus was significantly lower with an infusion rate of 7 micrograms/kg/min for 90 minutes.(ABSTRACT TRUNCATED AT 250 WORDS)

Coronary Thrombosis↗