The open artery: beyond myocardial salvage

Despite the potential limitations, the available data suggest the importance of the open artery as a marker of survival following infarction. Perhaps the most important, although as yet unanswered, question is when is it too late to reopen an artery? Further, is reperfusion by interventional techniques preferable to reperfusion by lytic therapy alone? Although a reduction in mortality has not been demonstrated for thrombolysis beyond 12 hours (other than the Second International Study of Infarct Survival, ISIS-2), improvements in ventricular function (which might translate into a survival benefit) have been demonstrated even for very delayed reperfusion. It is hoped that future work will allow us to answer better when such therapy might be preferable.