Skip to main content
Journal cover image

Optimizing the use of thrombolytics in ST-segment elevation myocardial infarction.

Publication ,  Journal Article
Morse, MA; Todd, JW; Stouffer, GA
Published in: Drugs
October 1, 2009

The advent of thrombolytic therapy was a major advance in the treatment of ST-segment elevation myocardial infarction (STEMI). The administration of fibrinolytic reperfusion therapy can reduce mortality rates by as much as 30%, with the greatest benefit observed if therapy is administered soon after symptom onset. Outcomes with thrombolytic therapy are improved if there is adjunctive treatment with aspirin, clopidogrel and an anti-thrombin agent. Although there is evidence that primary percutaneous coronary intervention (PCI) is the most effective reperfusion strategy, the majority of hospitals still do not have PCI capabilities and, thus, thrombolytic therapy remains a cornerstone of treatment for STEMI. Trials of thrombolytic therapy have demonstrated that initial patency rates can approach 85%, but there is still a need for improvement of non-invasive markers that predict failure or re-occlusion of the infarct-related artery. Because of the overwhelming data demonstrating the importance of rapid reperfusion, current studies are examining the role of earlier treatment of patients with STEMI via pre-hospital administration and/or coordinated systems for rapid diagnosis, transfer and delivery of definitive care. Facilitated PCI, a strategy of thrombolytic therapy followed by immediate PCI, has not been shown to be beneficial and current studies are examining the optimal timing of coronary angiography after thrombolytic therapy.

Duke Scholars

Published In

Drugs

DOI

EISSN

1179-1950

Publication Date

October 1, 2009

Volume

69

Issue

14

Start / End Page

1945 / 1966

Location

New Zealand

Related Subject Headings

  • Treatment Failure
  • Time Factors
  • Reperfusion
  • Pharmacology & Pharmacy
  • Myocardial Infarction
  • Humans
  • Fibrinolytic Agents
  • Electrocardiography
  • Drug Therapy, Combination
  • Coronary Thrombosis
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Morse, M. A., Todd, J. W., & Stouffer, G. A. (2009). Optimizing the use of thrombolytics in ST-segment elevation myocardial infarction. Drugs, 69(14), 1945–1966. https://doi.org/10.2165/11317670-000000000-00000
Morse, Michael A., Josh W. Todd, and George A. Stouffer. “Optimizing the use of thrombolytics in ST-segment elevation myocardial infarction.Drugs 69, no. 14 (October 1, 2009): 1945–66. https://doi.org/10.2165/11317670-000000000-00000.
Morse MA, Todd JW, Stouffer GA. Optimizing the use of thrombolytics in ST-segment elevation myocardial infarction. Drugs. 2009 Oct 1;69(14):1945–66.
Morse, Michael A., et al. “Optimizing the use of thrombolytics in ST-segment elevation myocardial infarction.Drugs, vol. 69, no. 14, Oct. 2009, pp. 1945–66. Pubmed, doi:10.2165/11317670-000000000-00000.
Morse MA, Todd JW, Stouffer GA. Optimizing the use of thrombolytics in ST-segment elevation myocardial infarction. Drugs. 2009 Oct 1;69(14):1945–1966.
Journal cover image

Published In

Drugs

DOI

EISSN

1179-1950

Publication Date

October 1, 2009

Volume

69

Issue

14

Start / End Page

1945 / 1966

Location

New Zealand

Related Subject Headings

  • Treatment Failure
  • Time Factors
  • Reperfusion
  • Pharmacology & Pharmacy
  • Myocardial Infarction
  • Humans
  • Fibrinolytic Agents
  • Electrocardiography
  • Drug Therapy, Combination
  • Coronary Thrombosis