Safe use of thrombolysis in the elderly

Elderly individuals with acute myocardial infarction represent a high-risk population that may benefit the most from thrombolytic therapy. To date, studies with streptokinase, tissue plasminogen activator (t-PA), and APSAC have shown improved survival in patients up to age 80, although there was an increased risk for hemorrhagic complications. While a placebo-controlled trial is needed to confirm these findings in even older patients, careful screening of the individual should make thrombolysis safe and effective for selected patients in this age group.