NEW THROMBOLYTICS, ADJUNCTIVE THERAPIES, AND MECHANICAL INTERVENTIONSFOR ACUTE ISCHEMIC SYNDROMES - A CURRENT PERSPECTIVE

Significant advances occurred in the management of acute coronary synd romes over the past two decades that have resulted in > 25% reduction in mortality from myocardial infarction (MI).(1) The incorporation of early thrombolysis and promptly recanalizing the occluded coronary art ery receive the major credit along with improvements in intensive coro nary care units (CCUs), chest pain centers, and activation of advanced emergency medical services (EMS) for prehospital treatment and resusc itation. However, acute MI (AMI) and its complications remain the lead ing causes of death and disability in the western world. In the past f ew years, aggressive interventions such as angioplasty, stents, and in tra-aortic balloon pumping (IABP) for managing acute coronary syndrome s have received significant attention. However, controversy regarding their usefulness in this setting remains. In this review article, we w ill address some of the pros and cons of such interventions, as well a s potential roles of newer thrombolytics and adjunctive therapies.