Thrombolytic therapy for unstable angina pectoris：a two-edged sword

• 作 者: 钱学贤 胡大一 贾国良 吴志坚
• 机 构: DepartmentofCardiology，ZhujiangHospital，1stMilitaryMedicalUniversity，Guangzhou，510282，China,Departme
• 出 处: 中华内科杂志
• 发表日期: 1998年37期

In recent years, the incidence of unstable angina pectoris （UAP） in hospitalized patients due to coronary artery disease （CAD） is increasing. oth anti-ischemic and anti-thrombotic agents are essential for UAP. They are highly effective in suppressing anginal symptoms,but fail to relieve or circumvent atherosclerotic obstructive lesions. Both early mortality and development of acute myocardial infarction （AMI） in patients with UAP have been significantly reduced with proper use of anti-platelet and anti-coagulant agents （either alone or in combination）, and might be further ecreased by newer specific thrombin inhibitors （hirudin, hirulog） and platelet glycoprotein （GP） Ⅱ b/ Ⅲ a receptor antagonists. Considering the definite role of intracoronary thrombosis in initiating of UAP and acute reocclusion after percutaneous transluminal coronary angioplasty （PTCA）, and also the high efficacy of thrombolytic therapy in the Q-wave AMI, it is reasonable to speculate that thrombolytic therapy might have beneficial results in the management of UAP. Yet angiographic and clinical trials have demonstrated that either thrombolytic therapy alone or prophylactic thrombolysis as an adjunct to PTCA should not be routinely recommended in the acute management of UAP.