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The evolution of thrombolytic therapy and adjunctive antithrombotic regimens in acute ST-segment elevation myocardial

Marc Cohen1, Heidar Arjomand, Charles V Pollack

  • 1Division of Cardiology, Newark Beth Israel Medical Center, Cardiac Cath Lav Administration, New Jersey 07112, USA. marcohen@sbhcs.com

The American Journal of Emergency Medicine
|January 16, 2004
PubMed

Insights

Pharmacologic therapy for ST-elevation myocardial infarction has evolved, with newer, simpler fibrinolytic drugs improving outcomes. Simplified regimens are clinically superior, enhancing emergency department and prehospital treatment for heart attacks.

Area of Science:

  • Cardiology
  • Emergency Medicine
  • Pharmacology

Background:

  • Acute ST-segment elevation myocardial infarction (STEMI) remains a leading cause of mortality.
  • Current treatments for STEMI have not eradicated risks of reinfarction, artery reocclusion, or stroke.

Purpose of the Study:

  • To review pharmacologic advances in STEMI treatment since 1986.
  • To evaluate the evidence for these advances in emergency departments (EDs).

Main Methods:

  • Review of significant trends in pharmacologic therapy for STEMI.
  • Analysis of fibrinolytic drugs with improved selectivity and pharmacokinetics.
  • Evaluation of evidence for simpler, easier-to-administer regimens.

Main Results:

  • Development of more selective and practical fibrinolytic agents.
  • Evidence suggests simpler administration regimens are clinically superior.
  • Advances facilitate earlier thrombolysis in EDs and prehospital settings.

Conclusions:

  • Pharmacologic therapy for STEMI has significantly advanced.
  • Simpler, more effective drug regimens improve patient outcomes.
  • These advances are crucial for effective emergency care of STEMI.

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