PMID- 7572574 OWN - NLM STAT- MEDLINE DCOM- 19951031 LR - 20190626 IS - 0002-8703 (Print) IS - 0002-8703 (Linking) VI - 130 IP - 4 DP - 1995 Oct TI - Concurrent nitroglycerin administration reduces the efficacy of recombinant tissue-type plasminogen activator in patients with acute anterior wall myocardial infarction. PG - 692-7 AB - The aim of this study was to evaluate the impact of concurrent nitroglycerin administration on the thrombolytic efficacy of recombinant tissue-type plasminogen activator (rTPA) in patients with acute anterior myocardial infarction (AMI). Sixty patients (53 men, 7 women; mean age 54 +/- 7 years) with AMI entered the study. Thirty-three patients were randomized to receive rTPA alone (100 mg in 3 hours) (group A) and 27 to receive rTPA plus nitroglycerin (100 micrograms/min) (group B). Time from the onset of chest pain and delivery of rTPA was similar in the two groups of patients. Patients in group A had signs of reperfusion more often than the patients in group B (25 of 33 or 75.7% vs 15 of 27 or 55.5%, p < 0.05). Time to reperfusion was also shorter in group A than in group B (19.6 +/- 9.4 minutes vs 37.8 +/- 5.9 minutes, p < 0.05). Group B had a greater incidence of in-hospital adverse events (9 of 27 vs 5 of 33, p < 0.05) and a higher incidence of coronary artery reocclusion (8 of 15 or 53.3% vs 6 of 25 or 24%, p < 0.05). Peak plasma levels of rTPA antigen were higher in group A compared with group B (1427 +/- 679 vs 512 +/- 312 ng/ml, p < 0.01). In conclusion, concurrent nitroglycerin administration reduces the thrombolytic efficacy of rTPA in patients with AMI probably by lowering the plasma levels of rTPA antigen. The diminished efficacy of rTPA is associated with an adverse outcome. FAU - Romeo, F AU - Romeo F AD - Department of Cardiology, University of Rome, Italy. FAU - Rosano, G M AU - Rosano GM FAU - Martuscelli, E AU - Martuscelli E FAU - De Luca, F AU - De Luca F FAU - Bianco, C AU - Bianco C FAU - Colistra, C AU - Colistra C FAU - Comito, M AU - Comito M FAU - Cardona, N AU - Cardona N FAU - Miceli, F AU - Miceli F FAU - Rosano, V AU - Rosano V AU - et al. LA - eng PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - 0 (Antigens) RN - EC 3.4.21.68 (Tissue Plasminogen Activator) RN - G59M7S0WS3 (Nitroglycerin) SB - IM CIN - Am Heart J. 1997 Jun;133(6):713-4. PMID: 9200401 MH - Antigens/blood MH - Drug Interactions MH - Drug Therapy, Combination MH - Female MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/*drug therapy/immunology MH - Nitroglycerin/*therapeutic use MH - *Thrombolytic Therapy MH - Tissue Plasminogen Activator/immunology/*therapeutic use MH - Treatment Failure EDAT- 1995/10/01 00:00 MHDA- 1995/10/01 00:01 CRDT- 1995/10/01 00:00 PHST- 1995/10/01 00:00 [pubmed] PHST- 1995/10/01 00:01 [medline] PHST- 1995/10/01 00:00 [entrez] AID - 0002-8703(95)90065-9 [pii] AID - 10.1016/0002-8703(95)90065-9 [doi] PST - ppublish SO - Am Heart J. 1995 Oct;130(4):692-7. doi: 10.1016/0002-8703(95)90065-9.