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A study was conducted to determine if thrombolytic therapy with tissue-type plasminogen activator (t-PA) is less effective in the morning. Studies have shown that the risk of myocardial infarction (MI) is higher in the morning, probably due to high levels of plasminogen activator inhibitor-1, which inhibits clot lysis by inhibiting t-PA. The results support the hypothesis that thrombolytic therapy is less effective in the morning., The effectiveness of thrombolytic therapy with tissue-type plasminogen activator (t-PA) appears to decline in the morning - when the risk of myocardial infarction is highest - and to increase in [...]

A recent study shows that acute myocardial infarction (MI) patients excluded from thrombolytic therapy have in-hospital mortality rates five times higher than patients who receive therapy. Current eligibility criteria exclude approximately 85% of acute MI patients from thrombolytic therapy. The study authors suggest that applicability of therapy needs to be broadened to include more acute MI patients.

Findings from the Global Utilization of Streptokinase and t-PA for Occluded Arteries (GUSTO) show that patients with acute myocardial infarction (MI) given tissue plasminogen activator (t-PA) within six hours are more likely to survive than patients who are treated with streptokinase. GUSTO involved 41,021 acute MI subjects from 16 countries. The study showed that the 30-day mortality rate was 6.3% for patients given t-PA and immediate and continuous intravenous heparin as compared to 7.3% who were treated with streptokinase., Acute myocardial infarction (MI) patients treated within 6 hours with accelerated tissue plasminogen activator (t-PA) are more likely to survive than patients who receive streptokinase, according to findings from the [...]