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Thrombolytic therapy: then and now.

P L Cole1

  • 1Washington University School of Medicine, St. Louis, MO.

Heart & Lung : the Journal of Critical Care
|September 1, 1991
PubMed
Summary

Thrombolytic therapy has revolutionized acute myocardial infarction treatment. While several agents exist, comparative studies show similar efficacy, establishing thrombolysis as the preferred treatment.

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Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Thrombolytic agents, discovered decades ago, have transformed acute myocardial infarction (AMI) care.
  • Four agents are approved: streptokinase, urokinase, tissue plasminogen activator (tPA), and anistreplase.

Purpose of the Study:

  • To review the current landscape of thrombolytic therapy for AMI.
  • To evaluate the efficacy and comparative effectiveness of available thrombolytic agents.

Main Methods:

  • Review of clinical studies and large-scale trials evaluating thrombolytic agents for AMI.
  • Analysis of various clinical endpoints including mortality, reperfusion, patency, and cardiac function.

Main Results:

  • All approved thrombolytic agents effectively dissolve fibrin clots by converting plasminogen to plasmin.
  • Comparative studies, including large trials, have not demonstrated significant differences in efficacy among the agents.
  • Key endpoints such as mortality, reperfusion, and cardiac function are consistently improved with thrombolytic therapy.

Conclusions:

  • Thrombolytic therapy is the established treatment of choice for acute myocardial infarction.
  • Despite a lack of consensus on a single superior agent, current options are effective.
  • Ongoing research focuses on new agents and optimized dosing regimens.

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