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European Heart Journal 1996 17(Supplement E):55-60; doi:10.1093/eurheartj/17.suppl_E.55
Copyright © 1996 by the European Society of Cardiology.
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© 1996 1996 The European Society of Cardiology

The future of thrombolysis in the treatment of acute myocardial infarction

C. Bode*, M. S. Runge{dagger} and R. W. Smalling{ddagger}

* Department of Cardiology, Medical Clinic III, University of Heidelberg Heidelberg, Germany
{dagger} Cardiology Division and Sealy Center for Molecular Cardiology, University of Texas Medical Branch Galveston, Texas, U.S.A.
{ddagger} Division of Cardiology, University of Texas Medical School at Houston Houston, Texas, U.S.A.

Correspondence. Christoph Bode, MD, Medizinische Kiinik III (Kardiologie), Universität Heidelberg, Bergheimerstraβe 58, 69115 Heidelberg, Germany

The ability of thrombolytic therapy to lower mortality in patients with acute myocardial infarction was first demonstrated in 1986 by the Gruppo Italiano per lo Studio della Streptochinasi nell'lnfarto Miocardico. In the ensuing 10 years, large efforts have been undertaken to develop more effective and safer thrombolytic agents. In addition, the value of adjunctive agents influencing thrombotic and thrombolytic processes was demonstrated, and newer agents are under active investigation. This review focuses on theoretical and practical aspects of optimizing thrombolytic therapy and on genetically engineered third generation plasminogen activators. Optimized thrombolytic therapy may make this form of therapy available to patients who are currently considered ineligible, and it will lead to earlier, more complete reperfusion of infarct-related coronary arteries. The benefits and risks of optimized thrombolytic regimens relative to those of mechanical reperfusion strat egies will require constant reassessment while both forms of treatment develop.

Key Words: Acute myocardial infarction • thrombolysis • plasminogen activators


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