Thrombolytic intervention and its effect on mortality in acute myocardial infarction: review of clinical trials

A review of six thrombolytic trials utilizing the endpoint of mortality shows that thrombolytic therapy and time to treatment are essential elements in reducing the mortality associated with acute MI. As a critical care nurse, one must incorporate this knowledge when putting this therapy into clinical practice. Clinical trials have demonstrated that thrombolytic therapy can indeed reduce mortality, but one must critically examine study data. It is difficult to compare the results of different studies with varying inclusion-exclusion criteria, sample size, study designs, and interventions. At present, it appears that t-PA plus heparin and aspirin therapy produces the lowest mortality at 14 days, 30 days, and 3 months after MI. In addition, the time-critical nature of thrombolytic therapy must be ingrained in the critical care nurse's assessment process. To reduce mortality in the patient with acute MI, assessment and initiation of therapy must be prompt.