Intravenous recombinant tissue-type plasminogen activator in acute myocardial infarction.

The efficacy and safety of intravenously administered recombinant tissue-type plasminogen activator (rt-PA, Boehringer Ingelheim Corp.) was investigated in 10 patients with acute myocardial infarction (AMI). rt-PA was given as a 10 mg bolus dose followed by infusions of 50 mg, 20 mg and 20 mg in three successive hours. All patients underwent baseline coronary angiography before thrombolytic therapy. Ninety minutes after the initiation of rt-PA infusion, recanalization of infarct-related coronary arteries as confirmed by angiography was achieved in 7 patients. The largest reduction in circulating fibrinogen was observed 4 to 6 h after the start of rt-PA infusion--14.3%. Moderate hemorrhage at the sites of arterial puncture occurred in 2 cases, probably as a result of heparin anticoagulation. No other side effects occurred. So rt-PA is an effective and safe thrombolytic agent.