Fibrin-selective fibrinolytic

If a fibrinolytic agent is administered, UFH is given concomitantly with alteplase, reteplase, and tenecteplase, but UFH is not administered with streptokinase because no benefit of combined therapy has been demonstrated. Rates of reinfarction are higher if UFH is not given with the fibrin-selective agents. 

Collen, D. (1998). Staphylokinase a potent, uniquely fibrin-selective thrombolytic agent. Nature Med. 4(3), 279-284. Collins, R. et al. (1997). Drug therapy—aspirin, heparin and fibrinolytic therapy in suspected acute myocardial infarction. N. Engl. J. Med. 336(12), 847-860. 

C. Reteplase binds to fibrin to cause a selective activation of fibrin-bound plasminogen. All fibrinolytic drugs are administered IV. Streptokinase is antigenic, whereas reteplase is not. Thrombocytopenia is not normally caused by thrombolytic drugs. 

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