Are We Using Fibrinolytic Agents Often Enough?
Authors: VICTOR J. MARDER
Journal: Annals of Internal Medicine (1980)

Editorial Notes1 July 1980Are We Using Fibrinolytic Agents Often Enough?VICTOR J. MARDER, M.D.VICTOR J. MARDER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-93-1-136 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe development and acceptance of new pharmacologic approaches to treatment are often painstakingly slow. Consider heparin: This drug is the standard anti-thrombotic agent for treating acute venous thrombosis and pulmonary embolism, but it took more than 20 years from the time of its discovery in 1916 (1) until its first clinical use for thrombosis (2). It was another 20 years before heparin was a popular alternative to surgical venous interruption as a means of preventing pulmonary embolism. Now consider thrombolytic agents: Streptokinase was not described until 1933 (3), urokinase until 1951 (4), and neither agent was administered therapeutically for thrombotic...References1. MCLEAN J. The thromboplastic action of cephalin. Am J Physiol. 1916;41:250-7. CrossrefGoogle Scholar2. MURRAYBEST DC. The use of heparin in thrombosis. Ann Surg. 1938;108:163-77. CrossrefMedlineGoogle Scholar3. TILLETTGARNER WR. The fibrinolytic activity of hemolytic streptococci. J Exp Med. 1933;58:485-502. CrossrefMedlineGoogle Scholar4. WILLIAMS J. The fibrinolytic activity of urine. Br J Exp Pathol. 1951;32:530-7. MedlineGoogle Scholar5. FLETCHERALKJAERSIGSMYRNIOTISSHERRY ANFS. The treatment of patients suffering from early myocardial infarction with massive and prolonged streptokinase therapy. Trans Assoc Am Physicians. 1958;71:287-96. MedlineGoogle Scholar6. The Urokinase Pulmonary Embolism Trial: a national cooperative study. Circulation. 1973;47(suppl):11-1-108. (American Heart Association Monograph Number 39). Google Scholar7. ELLIOTIMMELMANJEFFREY MEP. A comparative randomized trial of heparin versus streptokinase in the treatment of acute proximal venous thrombosis: an interim report of a prospective trial. Br J Surg. 1979;66:838-43. CrossrefMedlineGoogle Scholar8. MARDERSOULENATICHARTAKARN VRV. Quantitative venography assessment of deep vein thrombosis in the evaluation of streptokinase and heparin therapy. J Lab Clin Med. 1977;89:1018-29. MedlineGoogle Scholar9. Urokinase-Streptokinase Embolism Trial: phase 2 results: a cooperative study. JAMA. 1974;229:1606-13. CrossrefMedlineGoogle Scholar10. Medical Knowledge Self-Assessment Program V: Syllabus Part 2. Philadelphia: American College of Physicians; 1979. Google Scholar11. MARDER V. The use of thrombolytic agents: choice of patient, drug administration, laboratory monitoring. Ann Intern Med. 1979;90:802-8. LinkGoogle Scholar12. BELLMEEK WA. Guidelines for the use of thrombolytic agents. N Engl J Med. 1979;301:1266-70. CrossrefMedlineGoogle Scholar13. SHERRYBELLDUCKERT SWF. Thrombolytic therapy in thrombosis: a National Institutes of Health Consensus Development Conference. Ann Intern Med. 1980;93:141-4. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: VICTOR J. MARDER, M.D.Affiliations: Hematology Unit Department of Medicine University of Rochester School of Medicine and Dentistry Rochester, New York PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byThrombolytic therapy: 2001ThrombosisStreptokinase-plasminogen activator complex (BRL 26921) in the treatment of venous thromboembolismThoracic outlet syndromes: Update 1987Pulmonary embolus after treatment for subclavian-axillary vein thrombosisEffort-related axillosubclavian vein thrombosisStreptokinase Therapy in the Routine Management of Deep Venous Thrombosis in the Lower ExtremitiesPulmonary thromboembolic diseaseDecision to adopt new medical technology: A case study of thrombolytic therapyThe Postphlebitic SyndromePulmonary Emboli with Respiratory FailureThrombolytic TherapySTANLEY L. SCHRIER, M.D. 1 July 1980Volume 93, Issue 1_Part_1Page: 136-137KeywordsDrug discoveryDrugsHeparinPulmonary embolismThrombosis ePublished: 1 December 2008 Issue Published: 1 July 1980 PDF downloadLoading ...