Vandenbogaerde JF. Thrombolytic therapy and acute myocardial infarction.
Biomed Pharmacother 1989;
43:79-85. [PMID:
2660919 DOI:
10.1016/0753-3322(89)90134-0]
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Abstract
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.
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