Most Read Articles
26 Dec 2017
Supplementation with omega-3 fatty acids in combination with rosuvastatin may yield significant reductions in triglycerides and nonhigh-density lipoprotein (HDL) cholesterol as compared with rosuvastatin monotherapy, according to data from the ROMANTIC (rosuvastatin-omacor in residual hypertriglyceridemia) trial.
Elaine Soliven, 20 May 2020
Early treatment with a triple antiviral combination of lopinavir-ritonavir, ribavirin, and interferon beta-1b significantly shortens the duration of virus shedding and reduces symptoms in patients with mild-to-moderate COVID-19 compared with lopinavir-ritonavir only, according to a recent study.
Pearl Toh, 26 Sep 2019
The Singapore Health Sciences Authority (HSA) has recalled eight brands of ranitidine products containing trace amounts of the nitrosamine impurity NDMA*, which is a potential human carcinogen.
Rachel Soon, 24 Apr 2019

With recent recalls of losartan-containing products contaminated by potentially carcinogenic nitrosamines, MIMS speaks to the Malaysian National Pharmaceutical Regulatory Agency (NPRA) for more details.

Low-dose alteplase during PCI increases microvascular obstruction in STEMI patients

03 Apr 2020

Adjunctive treatment with low-dose intracoronary alteplase during primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) and an ischaemic time ≥4 to 6 h results in increased microvascular obstruction (MVO), a study has shown. Intracoronary alteplase appears to be unsafe for this subgroup.

No association was found between alteplase dose and the extent of MVO (ptrend=0.128), but alteplase increased the mean extent of MVO in patients with an ischaemic time ≥4 to 6 h compared with placebo (alteplase 10 mg vs 20 mg vs placebo: 3.11 percent vs 5.20 percent vs 1.13 percent; ptrend=0.009).

In addition, a statistically significant interaction was observed between ischaemic time and alteplase dose (p=0.018).

A total of 440 patients presenting with STEMI within 6 h of symptom onset (<2 h, n=107; ≥2 h but <4 h, n=235; ≥4 h to 6 h, n=98) and enrolled at 11 UK hospitals between 17 March 2016 and 21 December 2017 were included in this prospective, multicentre, parallel group, randomized, dose-ranging trial. Patients were randomly assigned to treatment with placebo (n=151), alteplase 10 mg (n=144) or alteplase 20 mg (n=145).

Ischaemic time was defined as the time from symptom onset to coronary reperfusion and was a prespecified subgroup of interest. The primary outcome of amount of MVO was quantified by cardiac magnetic resonance imaging at 2–7 days (available for 396 of 440 patients).

“Microvascular obstruction affects one-half of patients with STEMI and confers an adverse prognosis,” the investigators said.

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Most Read Articles
26 Dec 2017
Supplementation with omega-3 fatty acids in combination with rosuvastatin may yield significant reductions in triglycerides and nonhigh-density lipoprotein (HDL) cholesterol as compared with rosuvastatin monotherapy, according to data from the ROMANTIC (rosuvastatin-omacor in residual hypertriglyceridemia) trial.
Elaine Soliven, 20 May 2020
Early treatment with a triple antiviral combination of lopinavir-ritonavir, ribavirin, and interferon beta-1b significantly shortens the duration of virus shedding and reduces symptoms in patients with mild-to-moderate COVID-19 compared with lopinavir-ritonavir only, according to a recent study.
Pearl Toh, 26 Sep 2019
The Singapore Health Sciences Authority (HSA) has recalled eight brands of ranitidine products containing trace amounts of the nitrosamine impurity NDMA*, which is a potential human carcinogen.
Rachel Soon, 24 Apr 2019

With recent recalls of losartan-containing products contaminated by potentially carcinogenic nitrosamines, MIMS speaks to the Malaysian National Pharmaceutical Regulatory Agency (NPRA) for more details.