Thrombolytic therapy: How best to use in acute MI

Ralph J. Riviello, James W. Hoekstra

Research output: Contribution to journalArticlepeer-review


The choice of thrombolytic regimens can be a difficult one. Each agent has unique properties, and these must be understood before the correct choice can be made. Because of its bacterial origin, streptokinase may produce allergic reactions in a small percentage of patients; it is contraindicated in persons previously treated with it. Infarct-related patency rates of 60% to 70% have been reported with anistreplase, but this agent has not been shown to improve survival time when compared with other lytic drugs. Recombinant tissue plasminogen activator (rtPA) is fibrin-specific; its short half-life may permit vessel reocclusion, and concomitant heparin use is suggested. Reteplase, a good alternative, has a longer half-life and greater patency rates than rtPA, but survival rates are similar. Contraindications to thrombolytic therapy are conditions that put a patient at risk for bleeding and/or stroke.

Original languageEnglish (US)
Pages (from-to)2365-2376
Number of pages12
Issue number10
StatePublished - Dec 1 1998
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)


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