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      The Thrombolysis in Myocardial Infarction (TIMI) Trial : Phase I Findings

      The TIMI Study Group*

      New England Journal of Medicine

      Massachusetts Medical Society

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          Most cited references 21

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          Cloning and expression of human tissue-type plasminogen activator cDNA in E. coli.

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            Coronary thrombolysis with tissue-type plasminogen activator in patients with evolving myocardial infarction.

            Tissue-type plasminogen activator is a naturally occurring, clot-selective activator of fibrinolysis. We recently reported that human tissue-type plasminogen activator isolated from a Bowes-melanoma-tissue-culture supernate lysed coronary thrombi in dogs without depleting circulating fibrinogen or alpha 2-antiplasmin, in contrast to the case with streptokinase and urokinase. In the present study coronary thrombolysis, confirmed angiographically, was induced within 19 to 50 minutes with intravenous or intracoronary tissue-type plasminogen activator in six of seven patients with evolving myocardial infarction. Circulating fibrinogen, plasminogen, and alpha 2-antiplasmin were not depleted by this agent, in contrast to the case in the two patients subsequently given streptokinase. In the one patient in whom lysis was not inducible with tissue-type plasminogen activator, it was also not inducible with streptokinase. These observations indicate that clot-selective coronary thrombolysis can be induced in patients with evolving myocardial infarction by means of tissue-type plasminogen activator, without concomitant induction of a systemic lytic state. Definition of its therapeutic benefit must await greater availability of the agent and the performance of appropriate clinical trials.
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              Coronary thrombolysis with recombinant human tissue-type plasminogen activator: a prospective, randomized, placebo-controlled trial

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                Author and article information

                Journal
                New England Journal of Medicine
                N Engl J Med
                Massachusetts Medical Society
                0028-4793
                1533-4406
                April 04 1985
                April 04 1985
                : 312
                : 14
                : 932-936
                Article
                10.1056/NEJM198504043121437
                2004ba3e-3447-4ef4-8aae-c1b20ff02f57
                © 1985

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