TISSUE-PLASMINOGEN ACTIVATOR (T-PA)

Tissue plasminogen activator (t-PA) developed from recombinant DNA tec hnology is a highly effective thrombolytic agent. Its main clinical ap plication is in the treatment of acute myocardial infarction (MI), wit h most beneficial results occurring in patients treated early after th e onset of symptoms. When t-PA was compared with other thrombolytic ag ents, such as streptokinase (SK) and anisolyted plasminogen streptokin ase (APSAC), the data obtained from the mega trials (GISSI 2 and ISIS 3) revealed no significant difference in mortality. However, in the re cent GUSTO trial involving 41,000 patients, t-PA-treated patients had a significantly lower mortality rate compared to SK-treated patients. Aggressive adjunctive therapy, including intravenous heparin in combin ation with aspirin, may have accounted for this difference.