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. 1991;18(1):50–61.

Is Thrombolysis Alone the Best Therapy for Acute Myocardial Infarction?

Current Status and Emerging Strategies

Paolo Golino 1,2, James T Willerson 1,2
PMCID: PMC324960  PMID: 15227508

Abstract

Thrombolytic therapy has had a major impact on reducing mortality and preserving segmental ventricular function in patients with Q-wave infarcts who are treated early. Despite this substantial progress, a number of problems remain, most of which are related to the rate at which thrombolysis occurs and the risk of reocclusion of the infarct-related artery. Efforts need to be aimed at identifying and improving thrombolytic regimens that are capable of shortening the interval between the onset of ischemia and the achievement of reperfusion, as well as preventing reocclusion. Third-generation thrombolytic agents, including mutants of thrombolytic agents that are currently available, and different combinations of antiplatelet and thrombolytic regimens need to be tested for their abilities to reduce the time to thrombolysis and to delay or prevent reocclusion, without markedly increasing the risk of bleeding. Such adjunctive therapy might be provided by a variety of antiplatelet drugs, including combinations of thromboxane A2 synthesis inhibitors and receptor antagonists with serotonin receptor antagonists; thrombin antagonists; possibly platelet-activating factor antagonists; or monoclonal antibodies to the platelet receptors responsible for platelet attachment, platelet aggregation, or both. (Texas Heart Institute Journal 1991;18:50-61)

Keywords: Coronary thrombosis

Keywords: fibrinogen

Keywords: glycoproteins

Keywords: plasminogen activator, tissue-type

Keywords: platelet aggregation

Keywords: prostaglandins

Keywords: serotonin

Keywords: streptokinase

Keywords: thrombolytic therapy

Keywords: thromboxane A2

Keywords: urokinase

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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