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Review
. 2025 Mar;392(3):103392.
doi: 10.1016/j.jpet.2025.103392. Epub 2025 Jan 21.

Reperfusion of ischemia in the heart or brain

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Free article
Review

Reperfusion of ischemia in the heart or brain

Victor Gurewich et al. J Pharmacol Exp Ther. 2025 Mar.
Free article

Abstract

The current treatment of choice for an acute myocardial infarction (AMI) is an interventional procedure like percutaneous coronary intervention (PCI), which takes 2 to 3 hours and is not appropriate for clots in arteries smaller than the catheter. Because PCI requires inpatient catheterization, there is an inevitable delay in reperfusion of the ischemia. This delay was shown to have a linear relationship with AMI mortality. The longer the delay, from <5 minutes to >3 hours, the greater the cardiovascular disease mortality. Instead of PCI, a sequential combination of tissue-type plasminogen activator and prourokinase is the most effective treatment for conditions like AMI and ischemic stroke that mirrors the endogenous fibrinolytic process.

Keywords: Acute myocardial infarction; Percutaneous coronary intervention; Prourokinase; Tissue-type plasminogen activator; Urokinase.

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Conflict of interest statement

Conflict of interest Victor Gurewich is the Scientific Director of Thrombolytics Science, LLC. David Segarnick is an advisor to Thrombolytics Science.

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