CIRCADIAN VARIATION IN THE EFFICACY OF TISSUE-TYPE PLASMINOGEN-ACTIVATOR
CIRCADIAN VARIATION IN THE EFFICACY OF TISSUE-TYPE PLASMINOGEN-ACTIVATOR
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DOI：
10.1161/01.cir.91.5.1341
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发表时间：
1995-03-01
期刊：
影响因子：
37.8
通讯作者：
KURNIK, PB
中科院分区：
文献类型：
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作者：
KURNIK, PB
背景急性心肌梗死的发病频率遵循昼夜节律模式，发病高峰在上午6：00至中午。血小板聚集、纤溶酶原激活物抑制剂和许多止血和生理因素的昼夜节律变化已经被定义，所有这些都可能倾向于在上午晚些时候凝血和在晚上溶栓。因此，这一回顾性分析的假设是，组织型纤溶酶原激活剂（TPA）有更大的疗效时，中午和午夜之间，测量冠状动脉通畅90分钟后开始treatment.Methods和结果七百二十八例患者参加了两项研究中，TPA下管理的统一协议，用于治疗急性心肌梗死。其中，692例患者进行了合格的动脉造影，允许核心血管造影实验室对90分钟通畅率的主要终点进行标准化评估。TPA具有昼夜节律的疗效模式，当在中午和午夜之间给药时，TIMI 3级通畅率更高（P
Background The frequency of onset of acute myocardial infarction follows a circadian pattern, with a peak incidence between 6:00 AM and noon. Circadian variations have been defined for platelet aggregation, plasminogen-activator inhibitor, and a number of hemostatic and physiological factors, all of which might predispose toward clotting in the late morning and thrombolysis in the evening. Thus, the hypothesis for this retrospective analysis was that tissue-type plasminogen activator (TPA) has greater efficacy when administered between noon and midnight, as measured by coronary patency 90 minutes after initiation of treatment.Methods and Results Seven hundred twenty-eight patients were enrolled in either of two studies in which TPA was administered under a uniform protocol for the treatment of acute myocardial infarction. Of these, 692 patients had qualifying arteriograms that allowed standardized assessment by a core angiographic laboratory of the primary end point of 90-minute patency. TPA has a circadian pattern of efficacy, with greater TIMI grade 3 patency when administered between noon and midnight (P