Results of recent large myocardial infarction trials, adjunctive therapies, and acute myocardial infarction: improving outcomes.

Journal Article (Journal Article;Review)

Despite significant advances in the treatment of myocardial infarction, morbidity and mortality rates remain high. Recently completed, large, randomized trials have evaluated new therapeutic strategies for the management of ST-segment elevation acute myocardial infarction. Third generation fibrinolytic agents may offer advantages over conventional agents, such as more rapid, complete, and sustained reperfusion and greater ease of administration. However, no survival benefit has been observed. Direct thrombin inhibitors and low-molecular-weight heparins are being compared with unfractionated heparin as adjuncts to fibrinolytic therapy, and preliminary data suggest that these agents provide some clinical benefit when combined with streptokinase. More potent antiplatelet agents, such as the glycoprotein IIb/IIIa antagonists, may replace aspirin if they can be safely combined with fibrinolytic agents. These strategies are being tested in ongoing trials. Finally, agents such as adenosine and F2G may prevent reperfusion injury and improve myocardial salvage. The results of these trials have expanded our armamentarium of pharmacotherapy and should lead to improved clinical outcomes after acute myocardial infarction.

Full Text

Duke Authors

Cited Authors

  • Cantor, WJ; Ohman, EM

Published Date

  • July 1999

Published In

Volume / Issue

  • 7 / 4

Start / End Page

  • 232 - 244

PubMed ID

  • 10423675

International Standard Serial Number (ISSN)

  • 1061-5377

Digital Object Identifier (DOI)

  • 10.1097/00045415-199907000-00015


  • eng

Conference Location

  • United States