Thrombolytic therapy in acute myocardial infarction

Early reperfusion of thrombotically occluded coronary arteries by thromboly tic therapy has become a routine option in initial therapy of acute myocard ial infarction. Many efforts have been made to improve the biological prope rties of thrombolytic agents in terms of fibrin specificity, plasma half-li fe and resistance to natural plasma inhibitors, to improve adjuvant therapy and to shorten the 'pain to reperfusion' time, Numerous randomised, multic entre trials have analysed the benefit of the various thrombolytic agents a nd regimens, which has enabled the creation of a 'current standard of thera py'. This review presents an update on available thrombolytic agents, their bioc hemical and pharmacological properties and results from clinical trials.