Thrombolysis and Intervention in Acute Myocardial Infarction : An Overview

The use of thrombolytic agents in acute myocardial infarction (AMI) has been extensively studied for the past decade and a half and has become the standard of care for most patients presenting early in the course of AMI. Despite this general acceptance, there remains controversy over the choice of thrombolytic, the use of adjunctive anti-platelet and anti-thrombotic agents, the proper role for PTCA, especially direct PTCA, and the potential role for new interventional devices. The intent of this article is to examine in turn each of these areas, reviewing selected data from relevant trials. In so doing we shall develop an overall concept for reperfusion in AMI to quide our ongoing efforts at resolving our remaining therapeutic challenges.