The golden hours of the myocardial infarction: nonthrombolytic interventions.
Emergency care of patients with acute myocardial infarction requires active decision making to use agents that may improve morbidity and mortality. Thrombolysis remains the primary tool to accomplish this goal. Other pharmacologic agents, including lidocaine, nitrates, calcium channel blockers, beta-blockers, and aspirin, have been used acutely in myocardial infarction in the hopes of preventing death and salvaging myocardium. The decision to select one or all of these agents requires a knowledge of the clinical evidence of their efficacy and risk-to-benefit ratios. The clinical studies of the use of these agents acutely in the management of myocardial infarction are reviewed.
Mitchell
J M
JM
Department of Emergency Medicine, East Carolina University School of Medicine/Pitt County, Memorial Hospital, Greenville, North Carolina 27858-4354.
Wheeler
W S
WS
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use; D009203:Myocardial Infarction / Q000188:drug therapy*; D009566:Nitrates / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D002121:Calcium Channel Blockers; D009566:Nitrates; D008012:Lidocaine; D001241:Aspirin