Thrombolytic Therapy for Acute ST-Segment Elevation Myocardial Infarction

Thrombolytic therapy plays a crucial role in the management of acute ST-segment elevation myocardial infarction (STEMI). Commonly used medications include alteplase, reteplase, and prourokinase, which are effective in dissolving blood clots and restoring blood flow to the heart.

Timing and Eligibility for Thrombolytic Treatment

There is a critical time window for thrombolytic therapy, typically within 12 hours of symptom onset. Patients younger than 75 years old are generally considered better candidates for this treatment. However, certain contraindications must be ruled out before proceeding. These include a history of intracranial hemorrhage, recent surgery, or gastrointestinal bleeding, all of which can increase the risk of complications from thrombolytic drugs.

Important Considerations for Patient Safety

Severe hypertension is another important factor that can affect treatment decisions. If a patient's systolic blood pressure is higher than 180 mmHg, the risk of cerebral hemorrhage increases significantly, making thrombolytic therapy potentially dangerous and often contraindicated. Therefore, blood pressure control is essential before considering this intervention.

Modern Thrombolytic Agents and Success Rates

Once contraindications are ruled out, prompt treatment is essential. Newer thrombolytic agents such as prourokinase offer a safer profile and higher success rates compared to older drugs. These medications are designed to target the clot more effectively while minimizing systemic side effects, improving outcomes for patients with acute STEMI.