PMID- 2407374
OWN - NLM
STAT- MEDLINE
DCOM- 19900406
LR  - 20101118
IS  - 0009-7322 (Print)
IS  - 0009-7322 (Linking)
VI  - 81
IP  - 3 Suppl
DP  - 1990 Mar
TI  - Interventions in acute myocardial infarction.
PG  - IV43-50
AB  - Results of multiple studies have amply verified the benefit of urgent coronary 
      revascularization for patients who have acute myocardial infarction (MI). 
      Currently, intravenous thrombolytic therapy is the treatment of choice for many 
      patients, especially those 75 years old or younger who present within 6 hours of 
      symptom onset and who are without contraindications to thrombolytic therapy. Some 
      patients treated within 6-24 hours of symptom onset may also benefit, but this 
      remains unproven. The thrombolytic agents currently in use or being extensively 
      evaluated include streptokinase, urokinase, tissue-type plasminogen activator 
      (t-PA), anisoylated plasminogen streptokinase activator complex (APSAC or 
      anistreplase), and single-chain urokinase-type plasminogen activator (scu-PA). 
      The agent t-PA has the potential advantage of being clot selective and, thereby, 
      relatively fibrinogen sparing, and its efficacy in terms of restoration of vessel 
      patency is less dependent on the time of administration as compared with that of 
      streptokinase and urokinase. It is not yet known whether this will translate into 
      improved patient survival as compared with that achieved by the less-expensive 
      agents streptokinase and APSAC. Treatment regimens of combination thrombolytic 
      agents have been developed, but the optimal combinations have not yet been 
      determined. Patients who are in cardiogenic shock and those in whom thrombolytic 
      therapy is contraindicated can probably benefit from angioplasty or bypass 
      surgery. Results of several studies have suggested that immediate angioplasty 
      after successful thrombolysis is not beneficial; however, the potential benefit 
      of angioplasty or bypass surgery for failed thrombolytic therapy is yet to be 
      evaluated. Although many advances have been made, further research is clearly 
      needed in the area of reperfusion.
FAU - Ellis, S G
AU  - Ellis SG
AD  - Department of Internal Medicine, University of Michigan Medical Center, Ann 
      Arbor.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Circulation
JT  - Circulation
JID - 0147763
RN  - 0 (Drug Combinations)
RN  - 0 (Fibrinolytic Agents)
SB  - IM
MH  - Angioplasty, Balloon, Coronary
MH  - Coronary Artery Bypass
MH  - Drug Combinations
MH  - Evaluation Studies as Topic
MH  - Fibrinolytic Agents/adverse effects/therapeutic use
MH  - Humans
MH  - Myocardial Infarction/physiopathology/*therapy
MH  - Myocardial Reperfusion/standards
MH  - Postoperative Care
MH  - Time Factors
RF  - 63
EDAT- 1990/03/01 00:00
MHDA- 1990/03/01 00:01
CRDT- 1990/03/01 00:00
PHST- 1990/03/01 00:00 [pubmed]
PHST- 1990/03/01 00:01 [medline]
PHST- 1990/03/01 00:00 [entrez]
PST - ppublish
SO  - Circulation. 1990 Mar;81(3 Suppl):IV43-50.