Gc. Timmis et Sbh. Timmis, THE RESTORATION OF CORONARY BLOOD-FLOW IN ACUTE MYOCARDIAL-INFARCTION, Journal of interventional cardiology, 11(5), 1998, pp. 9-17
When an acute coronary syndrome degenerates into a myocardial infarcti
on the centerpiece of therapy is the normalization of myocardial blood
flow to the extent that it can be achieved in the shortest interval p
ossible after the onset of symptoms. A variety of strategies including
mechanical intervention have been used to achieve this goal, but the
benchmark therapy to which all other therapeutic alternatives must be
compared involves the use of thrombolytic agents. However, given the a
vailability of catheter laboratories and interventional expertise, mec
hanical reprefusion appears to be at least as good and probably better
thrombolytic therapy. Because of the universal access to thrombolytic
therapy, certain clinical issues must be underscored. More important
than pursuing the ideal thrombolytic agent is the administration of th
rombolytic therapy at the earliest possible juncture after onset of sy
mptoms heralding myocardial infarction. Adjunctive therapy includes as
pirin and intravenous heparin. Altering platelet activity by glycoprot
ein IIb/IIIa receptor blockers holds enormous promise for thrombolytic
therapy and PTCA, but as yet enjoys limited availability on a global
scale.