Navigation Links
Clot Dissolver Doesn't Boost Survival in Cardiac Arrest Patients
Date:12/17/2008

In study, those with pulmonary clots saw benefit,,,,

WEDNESDAY, Dec. 17 (HealthDay News) -- German doctors thought that giving the clot-dissolving drug tenecteplase (TKNase) to people with sudden cardiac arrest would improve survival.

Unfortunately, the drug, a form of tissue plasminogen activator (tPA), didn't work as hoped in a trial, but they haven't given up on the idea.

"In specific situations, those patients with pulmonary embolism, use of this thrombolytic agent can stabilize the patient and help the patient survive," said Dr. Bernd W. Böttiger, professor and head of the department of anesthesiology and emergency care medicine at the University of Cologne and lead author of a report in the Dec. 18 issue of the New England Journal of Medicine.

But pulmonary embolism, a blood clot that blocks a heart artery, is the underlying cause of sudden cardiac arrest only 5 percent to 7 percent of the time, Böttiger said. There was a small improvement in survival, though not great enough to be statistically significant, among people with pulmonary embolism in the trial he led, but there was no overall increase in the survival rate.

The trial, done at several European medical centers, was stopped after 443 people were treated for sudden cardiac arrest "because of low survival," the report said. It was started again with a change in the treatment routine but "terminated prematurely for futility after enrolling a total of 1,050 patients."

The 30-day survival rate was actually lower for people given tenecteplase: 14.7 percent versus 17 percent for those getting conventional treatment for cardiac arrest.

Better emergency treatments are desired because, Böttiger said, "in the U.S. and Europe every year, about 400,000 patients are suffering cardiac arrest, and only 5 to 10 percent will survive." The hope was that tenecteplase would dissolve artery-blocking clots that caused the hearts to stop, but it proved to be ineffective in the vast majority of patients -- those whose cardiac arrest was due to blockage of a major heart artery.

Failure to improve the overall survival rate was "a result that was not expected," Böttiger said. Although 17 percent of the people given standard emergency treatment in the trial survived, he attributed that the higher-than-average rate to the quality of care at the centers that participated in the study, describing it as "something that you can reach in such excellent emergency case systems, but only there."

Now the researchers are devising possible new trials with variations on the theme. "We haven't used thrombolysis [clot-busting] in combination with an anticoagulant," a drug that prevents formation of clots, Böttiger mused. "We could try heparin or other anticoagulants," he said. "We have several ideas and are working out different plans. I am absolutely convinced that it will result in a successful method. This is supported by a huge amount of animal studies, but the next step has not been decided."

Meanwhile, Böttiger said, administration of tenecteplase for someone who has sudden cardiac arrest "should be considered where pulmonary embolism is the suspected cause of the arrest."

Dr. Richard Pomerantz, clinical chief of cardiology at the University of Rochester in New York, said that giving a clot-busting drug such as tenecteplase when cardiac arrest is caused by a lung clot seems reasonable "because the heart itself is not in bad shape." But he said he is skeptical about its value when a heart artery blockage is the cause.

"First, there is small likelihood of being able to get the clot-dissolving medication to the area where it is needed because there is relatively low blood pressure," Pomerantz said. "Then, it takes awhile for it to work. It isn't a magic thing that opens the clot at once. It can take an hour or more for it to work."

"Thirdly, even if you open the artery, if someone has been without circulation for awhile, it's not only a question of getting it to restart but also to pump in an efficient manner," he said. "Often, what little effect you might produce is not enough to alter the outcome."

More information

To learn more about the why and how of tPa use, visit the American Heart Association.



SOURCES: Bernd Böttiger, M.D., professor and head, Department of Anesthesiology and Postoperative Intensive Care, University Hospital, University of Cologne, Germany; Richard Pomerantz, M.D., professor, medicine, and clinical chief, cardiology, University of Rochester, New York; Dec. 18, 2008,


'/>"/>
Copyright©2008 ScoutNews,LLC.
All rights reserved

Related medicine news :

1. ICU Nutritional Program Failed to Boost Outcomes
2. Sales of Energy-Boosting Diet Pills Skyrocket as the Economy Falters
3. New Genetic Analysis Might Boost Breast Cancer Care
4. Aflac Agents and Employees Boost Bone Marrow Registry
5. Playing Video Games May Boost Older Brains
6. LATH wins contract to boost health research capacity in Malawi
7. Seven life scientists get research boost to set up in Europe
8. Study Finds Doctors Use of E-Prescribing Systems Linked to Formulary Data Can Boost Drug Cost Savings
9. Brain Boosting Drugs vs. Walking: Treadmill Desk Manufacturer Promotes Common Sense
10. Poor Mental Health May Boost Asthma Risk
11. C-Section Might Boost Babys Asthma Risk
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/27/2016)... ... 27, 2016 , ... TherapySites, the leading website ... Tennessee Counseling Association. This new relationship allows TherapySites to continue to ... adding exclusive benefits and promotional offers. , "TCA is extremely excited about this ...
(Date:6/27/2016)... , ... June 27, 2016 , ... ... edge technology to revolutionize the emergency ambulance transport experience for the millions of ... of how Uber has disrupted the taxi industry through the use of technology. ...
(Date:6/26/2016)... ... ... Quality metrics are proliferating in cancer care, and are derived from many ... the beholder, according to experts who offered insights and commentary in the current issue ... the full issue, click here . , For the American Society of Clinical ...
(Date:6/26/2016)... , ... June 26, 2016 , ... Pixel Film Studios ... X. , "Film editors can give their videos a whole new perspective by using ... - CEO of Pixel Film Studios. , ProSlice Levels contains over 30 Different ...
(Date:6/26/2016)... ... ... blind and certified personal trainer is helping to develop a weight loss fitness plan that ... the two major problems leading the fitness industry today:, , All ... They don’t eliminate all the reasons people quit their exercise program , ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... Research and Markets has announced the addition of the ... to 2022" report to their offering. ... financial data derived from varied research sources to present unique ... on the market during the next five years, including a ... markets, regional and country level analysis. The report provides a ...
(Date:6/23/2016)... 23, 2016 Research and Markets has ... 52" report to their offering. ... creates a favourable commercial environment for MedImmune to enter. The ... that will serve to drive considerable growth for effective anti-influenza ... to cap sales considerably, but development is still in its ...
(Date:6/23/2016)... June 23, 2016 , , ... July 7, 2016 , , , , LOCATION: , , ... , , , EXPERT PANELISTS:  , , , Frost & ... Analyst, Christi Bird; Senior Industry Analyst, Divyaa Ravishankar and Unmesh Lal, ... The global pharmaceutical industry is witnessing an exceptional era. Several new ...
Breaking Medicine Technology: