Beta-blockade in myocardial ischemia: acute interventions in myocardial infarction.
The application of thrombolytic agents in acute myocardial infarction has shown to be an effective form of therapy in terms of reperfusion and improvement of myocardial function based on the reduction of infarct size, and decrease of mortality. From the presently available intravenous agents, urokinase and rT-PA have opening rates of 65 and 60%, respectively. The reperfusion rate as well as the improvement of myocardial infarction are time dependent, resulting in the necessity of reopening the occluded coronary artery within 2.5 h. From the available knowledge, time is not only the most important, but the medically most variable parameter. Thus, the need of early diagnosis and rapid installation of reperfusion result in the necessity of a broader instruction of the public and the treating physicians. Presently ongoing studies will show whether beginning therapy at home or in the ambulance may improve our already extremely promising results achieved today. They will, however, supposedly describe subgroups, i.e., of small inferior infarctions, in which conventional therapy has to be preferred instead of the more aggressive, subtle thrombolysis, PTCA, and cardiac surgery.
Bleifeld
W H
WH
Department of Cardiology/Medical Clinic, University Hospital Eppendorf, Hamburg, F.R.G.
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D006801:Humans; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000503:physiopathology
D000319:Adrenergic beta-Antagonists