Thrombolytic therapy for patients with acute myocardial infarction

Thrombolytic therapy is becoming an important addition to the care of patients with transmural (Q-wave) myocardial infarction. In this review, the authors analyze the mechanisms of effect and thrombolytic capabilities of several currently used thrombolytic interventions and review the influence of reperfusion in reducing mortality and protecting segmental ventricular function in animal models and patients. The problems related to thrombolytic therapy also are discussed and patient subgroups most likely to benefit from thrombolytic therapy identified. Finally, the authors speculate concerning future alterations in thrombolytic agents and additions to thrombolytic therapy as they might be usefully applied in the care of patients with acute transmural myocardial infarcts.