ACUTE CORONARY SYNDROME-FIBRINOLYTIC THERAPY

SUMMARY

1. Studies show most benefit in the first 4 hours and the greatest in the first hour. Most benefit in new BBB, anterior & inferior MI.

2. Start therapy within 30 min.

3. Following treatment with fibrinolytic therapy, high-risk STEMI patients (recurrent ischemia, cardiogenic shock, severe HF, or other high-risk features) should undergo coronary angiography and PCI at a different center immediately.

4. Fibrinolytic agents include the recombinant, rt-PA, TNK, anistreplase, streptokinase, and urokinase.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].