Thrombolysis in acute myocardial infarction: current status.
ST-segment elevation myocardial infarction (STEMI) is still a major public health problem in the modern world. Therapeutic options have changed much over the last 20 years, with a shift in favor of mechanical reperfusion over pharmacologic reperfusion. Thrombolytic therapy still has much to offer in the management of STEMI, however, because many patients do not have timely access to a facility with the required expertise for establishing mechanical reperfusion. This review highlights the history of thrombolytic therapy, adjunctive therapies, the relationship with mechanical reperfusion, and potential roles for thrombolysis in the future.
Kiernan
Thomas J
TJ
Division of Cardiovascular Diseases, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Gersh
Bernard J
BJ
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004359:Drug Therapy, Combination; D015507:Drugs, Investigational; D004632:Emergency Medical Services; D005342:Fibrinolysis / Q000502:physiology; D005343:Fibrinolytic Agents / Q000494:pharmacology / Q000627:therapeutic use; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D008274:Magnesium / Q000627:therapeutic use; D009203:Myocardial Infarction / Q000503:physiopathology / Q000628:therapy*; D009566:Nitrates / Q000627:therapeutic use; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D015912:Thrombolytic Therapy / Q000009:adverse effects / Q000379:methods*
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D015507:Drugs, Investigational; D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; D009566:Nitrates; D010975:Platelet Aggregation Inhibitors; D008274:Magnesium