Thrombolytic Therapy. From Myocardial to Cerebral Infarction. The MAST-I Group. Multicentre Acute Stroke Trial

Overview

Journal Ital J Neurol Sci

Specialty Neurology

Date 1996 Feb 1

PMID 8742984

Citations 1

Authors

L Candelise

C Roncaglioni

E Aritzu

A Ciccone

A P Maggioni

Affiliations

Soon will be listed here.

Abstract

Thrombolysis is proposed for the acute treatment of cerebral infarction as it is able to recanalize occluded arteries and thus potentially restore normal perfusion of the cerebral parenchyma, but the results concerning the efficacy of this treatment are still inconclusive. However, it has been fully demonstrated that thrombolytic treatment, leads to a significant reduction in mortality, in patients with acute myocardial infarction. Data from all of the pilot studies using SK or tPA treatment in acute stroke are described in this review, which underlines the incidence of hemorrhagic transformation (hemorrhagic infart and parenchymal hematoma) and its possible correlation to clinical worsening. Pharmacological, experimental and clinical studies encourage the carrying out of large-scale clinical trials using thrombolytics in patients with acute cerebral infarction. Significant data relating to ongoing controlled clinical trials will be available in the near future; only after the analysis of these results will it be possible to confirm the efficacy of thrombolytics in acute stroke.

Citing Articles

Thrombolysis for acute ischaemic stroke.

Wardlaw J, Murray V, Berge E, Del Zoppo G Cochrane Database Syst Rev. 2014; (7):CD000213.

PMID: 25072528 PMC: 4153726. DOI: 10.1002/14651858.CD000213.pub3.

References

. Coronary thrombolysis and myocardial salvage by tissue plasminogen activator given up to 4 hours after onset of myocardial infarction. National Heart Foundation of Australia Coronary Thrombolysis Group. Lancet. 1988; 1(8579):203-8. View

Marchal G, Serrati C, Rioux P, Viader F, De La Sayette V, Le Doze F . PET imaging of cerebral perfusion and oxygen consumption in acute ischaemic stroke: relation to outcome. Lancet. 1993; 341(8850):925-7. DOI: 10.1016/0140-6736(93)91214-7. View

. Very early thrombolytic therapy in suspected acute myocardial infarction. The Thrombolysis Early in Acute Heart Attack Trial Study Group. Am J Cardiol. 1990; 65(7):401-7. DOI: 10.1016/0002-9149(90)90800-g. View

Nenci G, Gresele P, Taramelli M, Agnelli G, Signorini E . Thrombolytic therapy for thromboembolism of vertebrobasilar artery. Angiology. 1983; 34(9):561-71. DOI: 10.1177/000331978303400901. View

Bamford J, Sandercock P, Dennis M, Burn J, Warlow C . A prospective study of acute cerebrovascular disease in the community: the Oxfordshire Community Stroke Project--1981-86. 2. Incidence, case fatality rates and overall outcome at one year of cerebral infarction, primary intracerebral and.... J Neurol Neurosurg Psychiatry. 1990; 53(1):16-22. PMC: 1014091. DOI: 10.1136/jnnp.53.1.16. View

Bar F, Verheugt F, Col J, Materne P, Monassier J, Geslin P . Thrombolysis in patients with unstable angina improves the angiographic but not the clinical outcome. Results of UNASEM, a multicenter, randomized, placebo-controlled, clinical trial with anistreplase. Circulation. 1992; 86(1):131-7. DOI: 10.1161/01.cir.86.1.131. View

von Kummer R, Hacke W . Safety and efficacy of intravenous tissue plasminogen activator and heparin in acute middle cerebral artery stroke. Stroke. 1992; 23(5):646-52. DOI: 10.1161/01.str.23.5.646. View

Meyer J, Gilroy J, Barnhart M, Johnson J . ANTICOAGULANTS PLUS STREPTOKINASE THERAPY IN PROGRESSIVE STROKE. JAMA. 1964; 189:373. DOI: 10.1001/jama.1964.03070050039011. View

Fieschi C, Argentino C, Lenzi G, Sacchetti M, Toni D, Bozzao L . Clinical and instrumental evaluation of patients with ischemic stroke within the first six hours. J Neurol Sci. 1989; 91(3):311-21. DOI: 10.1016/0022-510x(89)90060-9. View

10.

Lyden P, Zivin J . Hemorrhagic transformation after cerebral ischemia: mechanisms and incidence. Cerebrovasc Brain Metab Rev. 1993; 5(1):1-16. View

11.

Kassmeyer H, Widok W . [Thrombolysis in blocking of the internal carotid artery]. Med Welt. 1965; 31:1737-9 passim. View

12.

WILLIAMS D, Topol E, Califf R, Roberts R, Mancini G, Joelson J . Intravenous recombinant tissue-type plasminogen activator in patients with unstable angina pectoris. Results of a placebo-controlled, randomized trial. Circulation. 1990; 82(2):376-83. DOI: 10.1161/01.cir.82.2.376. View

13.

Brott T, Haley Jr E, Levy D, Barsan W, Broderick J, Sheppard G . Urgent therapy for stroke. Part I. Pilot study of tissue plasminogen activator administered within 90 minutes. Stroke. 1992; 23(5):632-40. DOI: 10.1161/01.str.23.5.632. View

14.

Marder V . Relevance of changes in blood fibrinolytic and coagulation parameters during thrombolytic therapy. Am J Med. 1987; 83(2A):15-9. DOI: 10.1016/0002-9343(87)90882-5. View

15.

Herderschee D, Limburg M, Hijdra A, Koster P . Recombinant tissue plasminogen activator in two patients with basilar artery occlusion. J Neurol Neurosurg Psychiatry. 1991; 54(1):71-3. PMC: 1014304. DOI: 10.1136/jnnp.54.1.71. View

16.

Ardissino D, Barberis P, De Servi S, Mussini A, Rolla A, Visani L . Recombinant tissue-type plasminogen activator followed by heparin compared with heparin alone for refractory unstable angina pectoris. Am J Cardiol. 1990; 66(12):910-4. DOI: 10.1016/0002-9149(90)90924-p. View

17.

Belz G . [Fibrinolytic therapy. Report on 5 year experience]. Munch Med Wochenschr. 1969; 111(45):2357-65. View

18.

Saran R, Bhandari K, Narain V, Ahuja R, Puri V, Thakur R . Intravenous streptokinase in the management of a subset of patients with unstable angina: a randomized controlled trial. Int J Cardiol. 1990; 28(2):209-13. DOI: 10.1016/0167-5273(90)90062-a. View

19.

Falk E . Coronary thrombosis: pathogenesis and clinical manifestations. Am J Cardiol. 1991; 68(7):28B-35B. DOI: 10.1016/0002-9149(91)90382-u. View

20.

Lincoff A, Topol E . Illusion of reperfusion. Does anyone achieve optimal reperfusion during acute myocardial infarction?. Circulation. 1993; 88(3):1361-74. DOI: 10.1161/01.cir.88.3.1361. View