Although thrombolytic therapy is used in a variety of settings, it has
gained the most prominence in the treatment of myocardial infarction.
The effectiveness of thrombolytic agents in reducing mortality in pat
ients who present with myocardial infarction has been clearly demonstr
ated by large-scale studies. Unfortunately, only a minority of patient
s who present with myocardial infarction are currently receiving throm
bolytic therapy. Many patients who could benefit from thrombolysis are
unnecessarily excluded from treatment. It is now recommended that all
patients who have appropriate electrocardiographic changes and presen
t within 12 hours of the onset of acute myocardial infarction be consi
dered for thrombolytic therapy. Factors such as age and history of pre
vious myocardial infarction are no longer viewed as barriers to treatm
ent.