Comparative Analysis of Therapeutic Efficacy and Adverse Reactions among Various Thrombolytic Agents

作者：Chenxi Xie, Naying Zheng, Mingmei Li, Zhiyang Zhang, Dongqin Huang, Meizhu Xiao, Dongdong Chen, Chengyong He, Zhenghong Zuo, Xintan Chen · 发表于：Toxics · 年份：2024 · DOI：10.3390/toxics12070458 · 被引用次数：7 · 研究领域：Antiplatelet Therapy and Cardiovascular Diseases、Venous Thromboembolism Diagnosis and Management、Acute Myocardial Infarction Research

Thrombosis is a major health concern that contributes to the development of several cardiovascular diseases and a significant number of fatalities worldwide. While stent surgery is the current recommended treatment according to the guidelines, percutaneous coronary intervention (PCI) is the optimal approach for acute myocardial infarction (AMI). However, in remote areas with limited resources, PCI procedures may not be feasible, leading to a delay in treatment and irreversible outcomes. In such cases, preoperative thrombolysis becomes the primary choice for managing AMI in remote settings. The market for thrombolytic drugs is continuously evolving, and identifying a safe and effective thrombolytic agent for treating AMI is crucial. This study evaluated Urokinase, Alteplase, and Recombinant Human TNK Tissue-type Plasminogen Activator for Injection (rhTNK) as representatives of first-, second-, and third-generation thrombolytic drugs, respectively. The research included in vitro thrombolysis experiments, exposure of human cardiomyocytes, zebrafish tail vein injections, and vascular endothelial transgenic zebrafish models. The findings revealed that rhTNK is the most effective thrombolytic drug with the least adverse effects and lowest bleeding rate, highlighting its potential as the preferred treatment option for AMI. The order of thrombolytic effectiveness was Urokinase < Alteplase < rhTNK, with adverse effects on cardiomyocytes post-thrombolytic therapy ranking similarly as U...