Systemic thrombolytic therapy of acute myocardial infarction?

The rationale for thrombolytic treatment of acute myocardial infarction is based on two established facts and a reasonable assumption. The first fact is that a thrombus obstructing an atherosclerotic coronary ar- tery is the most frequent precipitating cause of acute transmural infarction. The second fact is that intracor- onary administration of thrombolytic agents (strepto- kinase or urokinase) can reopen the occluded coronary artery within 1 hr and that reperfusion of ischemic myocardial tissue is generally well tolerated. The rea- sonable assumption is that timely reopening of an oc- cluded coronary artery will save myocardial tissue and therefore may improve myocardial function, reduce reinfarction rate, and possibly decrease early and late mortality.