CLINICAL SCIENCE REVIEW - CURRENT ASPECTS OF THROMBOLYTIC THERAPY IN WOMEN WITH ACUTE MYOCARDIAL-INFARCTION

Acute myocardial infarction (AMI) remains the greatest threat to healt h in our society and is the most common cause of death in the United S tates and in many other Western industrialized countries. Recent data demonstrate that mortality from MI is continuing to decline. In these days of more aggressive management of acute MI (AMI) there has been a resurgence of interest in advances in thrombolytic therapy. However, o bservational studies of patients with AMI have shown that women sustai ning an AMI have a worse prognosis than men. AMI is the number-one kil ler of women in the United States; approximately 247,000 of more than 520,000 deaths due to AMI that occur each year are among women, and al most one-third of the women are younger than forty-five years old. Whi le there have been great advances in thrombolytic therapy, these advan ces have benefited men to a more significant degree than they have ben efited women. The purpose of this paper is to critically review the ef ficacy of thrombolytic therapy in women with AMI with consideration of some of the key components of its effectiveness: mortality, bleeding risk, infarct-artery patency, ventricular function, and cardiac arrhyt hmia.