Thrombolytic therapy and acute myocardial infarction.
Coronary thrombosis and subsequent time-dependent wavefront cardiac muscle necrosis are the pathophysiological hallmarks of an acute myocardial infarction. Early treatment of the thrombus by intravenous thrombolytic therapy results in a major reduction of mortality by salvage of myocardial muscle and preservation of left ventricular function. Although the benefit of streptokinase has been best documented, second generation thrombolytics (APSAC and rt-PA) are probably superior thrombolytic agents. The data on the additive effect of inhibition of platelet aggregation with low dose acetylsalicylic acid on degree of thrombolysis and mortality after a myocardial infarction are convincing. The reduction in mortality brought about by intravenous thrombolytic therapy is highly time-dependent, so that its application in a patient presenting with an acute myocardial infarction must be considered as a race against time.
Vandenbogaerde
J F
JF
Department of Intensive Care, University Hospital, Gent, Belgium.
D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D009203:Myocardial Infarction / Q000188:drug therapy*
D005343:Fibrinolytic Agents