Recanalization of Coronary Arteries by Thrombolytic Agents in Acute Myocardial Infarction

Abstract

Fletcher et al. were the first to demonstrate the feasibility of intravenous thrombolytic therapy in acute myocardial infarctions [1]. Subsequently, at least twenty controlled trials were performed to assess the efficacy of intravenous thrombolysis in acute myocardial infarction using mortality as the primary end point [2–20]. Of the seven trials which showed statistically significant improvement of survival with intravenous thrombolytic therapy, six excluded patients with more than 12 hours of chest pain [2, 4, 5, 7, 8, 10]. The Third European trial demonstrated improved survival in patients with increased risk of mortality, as assessed prospectively on the basis of simple clinical criteria prior to randomization [10].