[Thrombolysis in myocardial infarction. Current status. Prospects].
Numerous data and controversies have arisen from studies concerning thrombolysis in acute myocardial infarction over the past five years. It is known that coronary artery obstruction is present in approximately 90 percent of acute infarctions during the first 4 hours of onset. Spontaneous renewed flow is noted in 30 percent of cases following the 12th hour, and in 50 percent of cases following the 3rd week. It is possible to obtain early renewed flow in 85 percent of cases with the administration of intracoronary streptokinase, and in 55 to 70 percent of cases with parenteral administration of streptokinase or urokinase. Controversy centers around the effectiveness of thrombolysis in limiting the size of the infarction, thus preserving cardiac function. Due to the numerous different protocols used and the insufficient number of cases reported in randomized studies, it is not possible to determine the superiority of one technique over another in preserving ischemic myocardium. After taking into account the technical constraints of the procedure and the contradictory published results, therapeutic fibrinolysis should remain a research modality as long as its effectiveness in preserving ischemic myocardium has not been established.
D003331:Coronary Vessels; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007263:Infusions, Parenteral; D007269:Injections, Intra-Arterial; D007275:Injections, Intravenous; D009203:Myocardial Infarction / Q000188:drug therapy*
D005343:Fibrinolytic Agents
La thrombolyse dans l'infarctus du myocarde. Etat actuel. Perspectives.