Coronary Thrombolysis with Intravenous Recombinant Tissue-Type Plasminogen Activator(rt-PA)

Eleven patients with acute myocardial infarction were treated with recombinant tissue-type plasminogen acrivator(rt-PA). The incidence of coronary thrombolysis, reocclusion and effect on the fibrinolytic system were studied. Dose of 1.25mg/kg up to 100mg of rt-PA was given intravenously for3 hours. Six of 7 patients(85.7%) on whom coronary angiography was performed within 90 min of initiation of therapy showed recanalization of the infarct-related artery and two of 3 patients at 24hrs. Reocclusion was demonstrated in one of 7 patients on whom repeat coronary angioplasty was performed at 15±5days. Blood fibrinogen level was higher than 100mg/dl after rt-PA infusion. One patients died during left ventriculography and there were no major bleeding complications. Thus intravenous rt-PA achieves high rate of recanalization without eliciting clinically significant fibrinogenolysis.