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Author: Admin | 2025-04-28
Degradation product. Incorporation of fragment X into hemostatic plugs formed at sites of vascular injury renders them susceptible to lysis. A trial comparing alteplase with streptokinase for treatment of patients with acute myocardial infarction demonstrated significantly lower mortality with alteplase than with streptokinase, although the absolute difference was small. The greatest benefit was seen in patients less than 75 years of age with anterior myocardial infarction who presented less than 6 hours after symptom onset. For treatment of acute myocardial infarction or acute ischemic stroke, alteplase is given as an intravenous infusion over 60 to 90 minutes. These properties have prompted studies comparing tenecteplase with alteplase in patients with acute ischemic stroke. Consequently, reteplase is given as two intravenous boluses, which are separated by 30 minutes. Activation of coagulation also triggers inflammatory pathways that may contribute to thrombogenesis. A better understanding of the biochemistry of blood coagulation and advances in structure-based drug design have identified new targets and resulted in the development of novel antithrombotic drugs. Well-designed clinical trials have provided detailed information on which drugs to use and when to use them. Despite these advances, however, arterial and venous thromboembolic disorders remain a major cause of morbidity and mortality. Therefore the search for better targets and more potent or more convenient antiplatelet, anticoagulant, and fibrinolytic drugs continues. Sutcliffe P, Connock M, Gurung T, et al: Aspirin for prophylactic use in the primary prevention of cardiovascular disease and cancer: a systematic review and overview of reviews. Fitzgerald R, Pirmohamed M:
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