Failed thrombolysis in myocardial infarction.
Prompt treatment with thrombolytic therapy in acute myocardial infarction has been proven to reduce infarct size and mortality. However, reperfusion fails to occur in 30-50% of patients, either due to impaired epicardial artery flow or microvascular occlusion, with these patients experiencing a higher morbidity and mortality. We review the diagnosis and management of failed thrombolysis in acute myocardial infarction.
Qasim
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St. Mary's Hospital, Portsmouth, UK. dr@asifqasim.freeserve.co.uk
Chauhan
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D000077284:Abciximab; D015906:Angioplasty, Balloon, Coronary; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D000991:Antithrombins / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004562:Electrocardiography; D005343:Fibrinolytic Agents / Q000276:immunology / Q000627:therapeutic use; D024764:Hirudin Therapy; D006629:Hirudins / Q000031:analogs & derivatives; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use; D008991:Monitoring, Physiologic; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000401:mortality / Q000628:therapy; D010446:Peptide Fragments / Q000627:therapeutic use; D010960:Plasminogen Activators / Q000276:immunology / Q000627:therapeutic use; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D011994:Recombinant Proteins / Q000627:therapeutic use; D012008:Recurrence; D013300:Streptokinase / Q000276:immunology / Q000627:therapeutic use; D015912:Thrombolytic Therapy; D013997:Time Factors
D000911:Antibodies, Monoclonal; D000925:Anticoagulants; D000991:Antithrombins; D005343:Fibrinolytic Agents; D006629:Hirudins; D007140:Immunoglobulin Fab Fragments; D010446:Peptide Fragments; D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D011994:Recombinant Proteins; D013300:Streptokinase; D010960:Plasminogen Activators; D001241:Aspirin; C074619:bivalirudin; D000077284:Abciximab