Current opinion in cardiology vol:7 issue:4 pages:595-601
Over the past year, the results of large-scale trials have better defined the risk to benefit ratios of thrombolytic therapy in specific subgroups of patients. However, important issues such as prevention of early reocclusion, prehospital administration of thrombolytics, adjunctive treatment with beta-blockers or angiotensin-converting enzyme inhibitors and early noninvasive detection of reperfusion remained unsolved. Encouraging data have been reported in selected patients for the more aggressive approach of direct angioplasty without thrombolysis. However, the results from large, randomized trials, comparing direct angioplasty with conventional thrombolysis, are still lacking. A postthrombolysis strategy of watchful waiting has been corroborated by new findings.