[Acute myocardial infarction: prehospital phase and first hospital days]

During acute myocardial infarction, pre-hospital stage and the first hours after admission are crucial for initiating reperfusion therapy, which is determinant for short- and mid-term survival. Within 12 hours after onset of chest pain, either thrombolysis or primary angioplasty contribute to reduce mortality rate, the earlier being the better. Therapeutic advances, regarding either thrombolysis or angioplasty, are directed towards an earlier, more efficient and stable (without reocclusion) patency of the infarct-related artery. Most promising results so far have been obtained with platelet glycoprotein (GP) IIb/IIIa receptor blockers, in combination with thrombolysis or angioplasty.