Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SATURDAY, March 28, 1992 TAG: 9203280109
SECTION: NATIONAL/INTERNATIONAL PAGE: A7 EDITION: NEW RIVER VALLEY
SOURCE:
DATELINE: LENGTH: Medium
T-PA, a clot-busting drug, has been the subject of vigorous debate in medical circles and fierce competition in the pharmaceutical market. The study adds to evidence that the more expensive drug provides no clinical advantages.
"The difference between the various thrombolytic [clot-dissolving] agents is minimal in terms of benefit. In my opinion, this study definitively shows that," said Salim Yusuf, a cardiologist at the National Institutes of Health who helped run the trial.
The results were published in the British journal Lancet.
A heart attack is caused when a blood clot forms on a narrowed section of a coronary artery, blocking flow of blood to the heart muscle. Both t-PA - short for tissue plasminogen activator - and streptokinase are clot-dissolving drugs given intravenously in the hours after symptoms of heart attack begin.
Both drugs markedly improve a person's chance of surviving a heart attack. Their chief risk is stroke or bleeding in the brain.
Among the debated questions is whether t-PA - a human substance made in industrial quantities by genetic engineering - is on balance more effective than streptokinase, a protein extracted from the streptococcus genus of bacteria.
In the recent study there was no significant difference in mortality in the streptokinase group, compared to those who got t-PA. But there was a statistically significant increase in the number of strokes with t-PA. Patients who got t-PA had fewer second heart attacks immediately after the first than patients who got the other drugs.
The wholesale price for t-PA is $2,750 a treatment. Streptokinase costs about $400, according to the 1992 Drug Topics Red Book.
- The Washington Post
Memo: shorter version ran in the Metro edition.