What Are Clot Busters And How Do They Work?

Dr. Becker answers the question: 'What Are Clot Busters, How Do They Work?'

ByRichard C. Becker, M.d., Director, Cardiovascular Thrombosis Center, Duke University Medical Center
November 19, 2008, 5:22 PM

— -- Question: What are clot busters and how do they work?

Answer: Clot busters were developed approximately twenty years ago now with the intent of reducing the likelihood of death following a heart attack. We know from years of experience that heart attacks in a majority of individuals are caused by a blood clot forming inside a blood vessel with atherosclerosis, or hardening of the arteries.

The clot busters were developed after many years of research to dissolve blood clots, and as a result, reduce the extent of heart damage in the setting of a heart attack. The degree of heart damage actually determines whether someone would live or die as a result of a heart attack. By dissolving a blood clot that causes a heart attack, we'll reduce the subsequent degree or extent of injury to the heart muscle and therefore, reduce the likelihood of death from a heart attack.

They're used frequently in both the United States and in countries outside of the United State for people typically within the first six hours of signs or symptoms of a heart attack.

This particular group of medicines can also be used for individuals with stroke, specifically what is known as an 'ischemic stroke' that is also -- like a heart attack -- caused by a small blood clot that lodges within a blood vessel that has atherosclerosis.

When clot busting medicines are used within the first three hours of someone with a stroke, the degree of injury and the degree of compromise or weakness that may be caused from the stroke will be reduced. However, they are not known to be beneficial outside of that initial three hours, and as a result, for either heart attack or stroke, it is vital that a person recognize the signs and symptoms, initiate 911, and come to the hospital quickly, where medications can be used to reduce the size of a heart attack or reduce the size of a stroke.

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