Key result
Recombinant tPA remains essential for acute STEMI reperfusion when primary PCI is unavailable.
Why the study?
Although PPCI is the treatment of choice for STEMI, fibrinolytics including recombinant tissue-type plasminogen activators remain important where PPCI is unavailable, necessitating review of their use and timing.
This review discusses the use of recombinant tissue plasminogen activators for acute STEMI management and emphasizes the importance of timely reperfusion when primary PCI is not readily available.
Fibrinolytics retain a role where timely PPCI is unavailable; level 5 data leave optimal contemporary use open.
Although acute ST elevation myocardial infarction (STEMI) was described nearly a century ago, it remains a major health problem not only in the U.S. but also worldwide with more than three million people suffering STEMI every year. Primary percutaneous coronary intervention (PPCI) is now the treatment of choice for the management of patients with STEMI. In the 20th century, fibrinolytics were the agents of choice for the management of patients with acute STEMI and they continue to be utilized in centers where PPCI facilities are not readily available. Large-scale trials were performed comparing streptokinase and new agents such as the recombinant tissue-type plasminogen activators. This article discusses the use of recombinant tissue plasminogen activators for the management of patients with acute STEMI and the importance of restoring optimal timely reperfusion of the myocardium.
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Kunadian et al. (2011) conducted a review in Acute ST elevation myocardial infarction (STEMI). Recombinant tissue-type plasminogen activators was evaluated. Recombinant tissue plasminogen activators remain important for managing acute STEMI when primary percutaneous coronary intervention is unavailable, emphasizing the need for timely reperfusion.
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