An approach to evaluating thrombolytic therapy in acute myocardial infarction. The 'unsatisfactory outcome' end point.

An approach to evaluating thrombolytic therapy in acute myocardial infarction. The 'unsatisfactory outcome' end point.

Evaluating Thrombolytic Therapy in Acute Myocardial Infarction

T he primary goal of thrombolytic therapy in acute myocardial infarction (AMI) is the early restoration of perfusion and maintenance of viability and function of myocardium that would otherwise undergo necrosis consequent to thrombotic coronary artery occlusion. The salvage achieved by thrombolysis ranges from a minute amount of myocardium of little functional significance to a large mass of he...

Thrombolytic therapy in acute myocardial infarction Paul

Infarct size limitation has been a therapeutic aim for many years, particularly in view of the known close relationship between the extent of myocardial damage occurring at the time of the infarction, and future morbidity and mortality. It is only in the last decade, however, since the pathophysiology of myocardial infarction has been better understood, that this aim has become a clinical reali...

Thrombolytic therapy in acute myocardial infarction.

Despite major advances made over the last decade, mortality following acute myocardial infarction (MI) is still high even for patients treated with the "front-loaded" recombinant tissue-type plasminogen activator (rt-PA) regimen: 30-day mortality is 6.3%, and it is associated with fatal cerebral hemorrhage in 1.5%. Further improvement of short- and long-term prognosis can be achieved if infusio...

Thrombolytic therapy in acute myocardial infarction.

Pathophysiology Myocardial infarction (MI) usually occurs as a result of plaque rupture, resulting in thrombus formation. Atherosclerotic plaques form over time in arteries. The plaque consists of soft atheroma, an infiltration of white blood cells engulfs the lipid and forms foam cells and a fibrous cap. The plaque can rupture as a result of many factors, including stress from blood flow, infl...