Document Detail

Early myocardial reperfusion: an assessment of current strategies in acute myocardial infarction.
MedLine Citation:
PMID:  11824003     Owner:  NLM     Status:  MEDLINE    
Early, complete, and sustained myocardial reperfusion is the principal goal of thrombolytic therapy. Unfortunately, the majority of patients treated today experience substantial delay before the initiation of thrombolytic therapy and, once treated, demonstrate suboptimal results of coronary thrombolysis. This is attributable, in part, to the underlying thrombus, which is platelet rich and resistant to plasminogen activators, and to the pro-thrombotic effects of fibrinolytics, which have no favourable effect on thrombin. Future therapeutic interventions will focus on improved reperfusion. Pharmacological strategies including novel plasminogen activators, direct thrombin inhibitors, and platelet glycoprotein IIb/IIIa inhibitors have all generated encouraging early clinical trial data and await further study. Mechanical reperfusion therapy with primary balloon angioplasty is particularly effective; its use is associated with the establishment of more complete infarct vessel patency than are thrombolytics. Considerable potential for the improvement of current reperfusion-directed therapy exists.
E J Topol
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  European heart journal     Volume:  17 Suppl E     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  1996 Sep 
Date Detail:
Created Date:  2002-02-04     Completed Date:  2002-02-14     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  42-8     Citation Subset:  IM    
Department of Cardiology, Joseph J. Jacobs Center for Thrombosis and Vascular Biology, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, Ohio 44195, USA.
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MeSH Terms
Drug Administration Schedule
Emergency Treatment
Fibrinolytic Agents / administration & dosage*
Myocardial Infarction / drug therapy*,  mortality
Myocardial Reperfusion*
Randomized Controlled Trials as Topic
Time Factors
Reg. No./Substance:
0/Fibrinolytic Agents

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