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Thromb Haemost 2004; 92(06): 1194-1200
DOI: 10.1160/TH04-02-0072
Theme Issue Article
Schattauer GmbH

A marriage of enhancement: fibrinolysis and conjunctive therapy

Robert C. Welsh
1   The University of Alberta, Department of Medicine, Division of Cardiology, Edmonton, Canada
,
Paul W. Armstrong
1   The University of Alberta, Department of Medicine, Division of Cardiology, Edmonton, Canada
› Author Affiliations
Further Information

Publication History

Received 05 February 2004

Accepted after revision 06 May 2004

Publication Date:
02 December 2017 (online)

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Summary

Pharmacologic reperfusion of patients with acute ST segment elevation myocardial infarction is designed to achieve prompt high-quality reperfusion, prevent recurrent ischemia and reinfarction, maintain long-term patency, and to enhance patient survival and quality of life. Because monotherapy with fibrinolytics is by itself unable to achieve all of these objectives, antithrombotic, anti-platelet, and other novel agents are required. We discuss herein the role of unfractionated and enoxaparin, the potential added value of direct thrombin inhibitors, and the importance of aspirin. Despite the promise of glycoprotein IIb/IIIa inhibitors, risks associated with intracranial hemorrhage in the elderly have led to restraint in their application to broad populations. Facilitation of urgent percutaneous coronary intervention with combination reduced-dose fibrinolytic and glycoprotein IIb/IIIa inhibitors remains a promising potential future path. The future is likely to emphasize greater application of the already effective therapies at our disposal and the development of novel anti-platelet and anti-thrombin agents as well as those directed toward inflammation.

Keywords

Clinical trials - fibrinolytic therapy - clinical trials - heparins / LMWH
 

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