Thrombolytic therapy: current status - summary

Canadian Coordinating Office for Health Technology Assessment
Record ID 31995000010
English, French
Authors' objectives:

To identify current controversies and emerging trends about thrombolytic therapy, and examine potential impact in Canada

Authors' results and conclusions: a)The ISIS-3 trial shows no difference in survival between streptokinase, tPA and ASPAC; the debate continues on optimal dosing and administration rates; b) The time between onset of symptoms of AMI and therapy is the most critical factor in achieving significant myocardial salvage and reduced mortality; c) Controversy over patient selection continues; d) There is evidence that adjunctive therapies with anticoagulants or antiplatelets improve efficacy of thrombolytic therapy; e) Approximate costs per treatment are: tPA - $2900, streptokinase - $400, ASPAC - $1900, urokinase - $775. Estimated annual total drug cost in Canada are $77 million (tPA), $51 million (ASPAC) and $12 million (streptokinase).
Authors' recommendations: Future directions include research into earlier administration, noninvasive detection of reperfusion, enhancement of early patency, prevention of reocclusion and reduction of complications.
Authors' methods: Review
Project Status: Completed
URL for project:
Year Published: 1992
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Canada
MeSH Terms
  • Anistreplase
  • Myocardial Infarction
  • Plasminogen Activators
  • Streptokinase
  • Tissue Plasminogen Activator
  • Urokinase-Type Plasminogen Activator
  • Fibrinolytic Agents
Organisation Name: Canadian Coordinating Office for Health Technology Assessment
Contact Address: 600-865 Carling Avenue, Ottawa, ON K1S 5S8 Canada. Tel: +1 613 226 2553, Fax: +1 613 226 5392;
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Copyright: Canadian Coordinating Office for Health Technology Assessment.
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.