Fibrinolytic Therapy in Patients with Acute ST-elevation Myocardial Infarction

Chayakrit Krittanawong; Joshua Hahn; Waleed Kayani; Hani Jneid

doi:10.1016/j.iccl.2021.03.011

Fibrinolytic Therapy in Patients with Acute ST-elevation Myocardial Infarction

Interv Cardiol Clin. 2021 Jul;10(3):381-390. doi: 10.1016/j.iccl.2021.03.011.

Authors

Chayakrit Krittanawong¹, Joshua Hahn¹, Waleed Kayani¹, Hani Jneid²

Affiliations

¹ Section of Cardiology, Baylor College of Medicine, 7200 Cambridge Street, Houston, TX 77030, USA.
² Section of Cardiology, Baylor College of Medicine, 7200 Cambridge Street, Houston, TX 77030, USA; Interventional Cardiology Fellowship Program, Interventional Cardiology Research, Baylor College of Medicine, Interventional Cardiology, The Michael E. DeBakey VA Medical Center, MEDVAMC - 2002 Holcombe Boulevard, Cardiology 3C-320C, Houston, TX 77030, USA. Electronic address: jneid@bcm.edu.

PMID: 34053624
DOI: 10.1016/j.iccl.2021.03.011

Abstract

Fibrinolytic agents provide an important alternative therapeutic strategy in individuals presenting with ST-elevation myocardial infarction (STEMI). Ultimately, primary percutaneous coronary intervention (PCI) is the preferred reperfusion strategy for most patients with STEMI, including elderly patients and patients with coronavirus disease 2019 (COVID-19) infection. Fibrinolytic therapy should always be considered when timely primary PCI cannot be delivered appropriately. Clinicians should promptly recognize the signs of fibrinolytic therapy failure and consider rescue PCI. When fibrinolytics are used, coronary angiography and revascularization should not be conducted within the initial 3 hours after fibrinolytic administration.

Keywords: Fibrinolytic; Heart; Percutaneous coronary intervention; ST-segment myocardial infarction.

Publication types

Review

MeSH terms

Fibrinolytic Agents / therapeutic use
Humans
ST Elevation Myocardial Infarction / drug therapy*
Thrombolytic Therapy* / methods

Substances

Fibrinolytic Agents