The role of PTCA in acute myocardial infarction

2 closing remarks should be made. In the 1st place: Under optimal conditions (experienced house staff and experienced interventional cardiologists, well equipped catheterization laboratory all available on a 24 hour service) primary PTCA can be done safely with excellent results as demonstrated by Hartzler et al. and by the Zwolle study. In the 2nd place: Recent reports have demonstrated better results from a combination of thrombolytic agents and probably this is due to higher patency rates and possibly less deleterious effects on plaque morphology and ischemic myocardium. Anti platelet therapy is still a major concern because of the limited efficacy of aspirin and heparin. Specific binding of platelet membrane glycoprotein. IIB/IIIA to monoclonal antibodies (7E3 Fab) is a promising and potential new concept. Other agents may also be effective of which hirudin and angiopeptin should be mentioned. All these factors may contribute to a better treatment strategy for acute myocardial infarction.