Clinical applications of thrombolytic therapy

Although thrombolytic therapy is used in a variety of settings, it has gained the most prominence in the treatment of myocardial infarction. The effectiveness of thrombolytic agents in reducing mortality in patients who present with myocardial infarction has been clearly demonstrated by large-scale studies. Unfortunately, only a minority of patients who present with myocardial infarction are currently receiving thrombolytic therapy. Many patients who could benefit from thrombolysis are unnecessarily excluded from treatment. It is now recommended that all patients who have appropriate electrocardiographic changes and present within 12 hours of the onset of acute myocardial infarction be considered for thrombolytic therapy. Factors such as age and history of previous myocardial infarction are no longer viewed as barriers to treatment.