New Thrombolytics, Adjunctive Therapies, and Mechanical Interventions for Acute Ischemic Syndromes: A Current Perspective

Significant advances occurred in the management of acute coronary syndromes over the past two decades that have resulted in > 25% reduction in mortality from myocardial infarction (MI). 1 The incorporation of early thrombolysis and promptly recanalizing the occluded coronary artery receive the major credit along with improvements in intensive coronary care units (CCUs), chest pain centers, and activation of advanced emergency medical services (EMS) for prehospital treatment and resuscitation. However, acute MI (AMI) and its complications remain the leading causes of death and disability in the western world. In the past few years, aggressive interventions such as angioplasty, stents, and intra‐aortic balloon pumping (IABP)for managing acute coronary syndromes have received significant attention. However, controversy regarding their usefulness in this setting remains. In this review article, we will address some of the pros and cons of such interventions, as well as potential roles of newer thrombolytics and adjunctive therapies.