What is the role of fibrinolytic therapy in the treatment of acute myocardial infarction (AMI)?

Updated: Dec 31, 2017
  • Author: Wanda L Rivera-Bou, MD, FAAEM, FACEP; Chief Editor: Erik D Schraga, MD  more...
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Answer

Answer

Fibrinolytic therapy is a proven treatment for the management of AMI. It is more universally available to patients without contraindications, can be administered by any properly trained health care provider, and can be given in the prehospital setting. Its efficacy declines as the duration of ischemia increases. The goal is a door-to-needle time of less than 30 minutes, and every effort must be made to minimize the time to therapy. Patients older than 75 years derive significant benefit from fibrinolytic therapy, even though their risk of bleeding is higher.

Fibrinolytic agents are given in conjunction with antithrombin and antiplatelet agents, which help to maintain vessel patency once the clot has been dissolved.


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