Does systemic thrombolytic therapy improve outcomes in patients with acute myocardial infarction?
The rationale for thrombolytic therapy in acute MI is based on the ability of agents like streptokinase or urokinase to reopen occluded coronary arteries and potentially improve clinical outcomes.
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.
Collen et al. (Mon,) studied this question.