Adjunctive therapy after reperfusion therapy in acute myocardial infarction.
The current era has witnessed dramatic improvement in the treatment of acute myocardial infarction, due in large part to the more widespread use of thrombolytic therapy aimed at quickly restoring perfusion in the infarct-related artery. This review addresses the role of adjunctive pharmacologic therapy in the thrombolytic era, recognizing that much of the available clinical trial data supporting the role of adjunctive pharmacologic treatment strategies was conducted in patient populations not widely exposed to reperfusion therapy. This review, therefore, explores the data supporting the incremental benefit of therapy with beta blockers, nitrates, angiotensin-converting enzyme inhibitors, or magnesium in addition to thrombolytic therapy. Heparin and aspirin will not be discussed.
Dries
D L
DL
Division of Cardiology, Georgetown University Hospital, Washington, D.C., USA.
Solomon
A J
AJ
Gersh
B J
BJ
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008274:Magnesium / Q000627:therapeutic use; D009203:Myocardial Infarction / Q000188:drug therapy*; D015425:Myocardial Reperfusion; D014665:Vasodilator Agents / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D005343:Fibrinolytic Agents; D014665:Vasodilator Agents; D008274:Magnesium