Thrombolytic Therapy for Acute Myocardial Infarction
Jun 01, 2022
Source: Cainiu Health
Dr. Li Man
Introduction
Thrombolytic therapy can be classified into two types based on the route of drug administration: intracoronary thrombolysis and intravenous thrombolysis. Intracoronary thrombolysis involves first inserting a catheter into the coronary artery via an artery, followed by injection of urokinase or streptokinase directly into the coronary artery to dissolve the thrombus; its success rate ranges from 68% to 89%. Intravenous thrombolysis does not require catheterization and is typically performed within a hospital setting—even in an ambulance.
Acute myocardial infarction (AMI) is a relatively common condition in daily life, with a rapidly rising incidence and potentially life-threatening consequences if severe.
Thrombolytic Therapy for Acute Myocardial Infarction
Thrombolytic therapy can be administered either directly into the coronary artery (intra-coronary thrombolysis) or intravenously (intravenous thrombolysis). In intra-coronary thrombolysis, a catheter is inserted via an artery into the coronary artery, followed by injection of urokinase or streptokinase to dissolve the intracoronary thrombus; this approach achieves success rates of 68%–89%. However, because intra-coronary thrombolysis requires arterial catheterization—which may cause treatment delays—intravenous thrombolysis has become more widely adopted in recent years. Intravenous thrombolysis does not require catheter insertion and can be performed within the hospital—or even aboard an ambulance—making it more practical and broadly applicable. Typically, 500,000–1,500,000 units of streptokinase are administered intravenously over approximately 30 minutes, yielding efficacy rates ranging from 50% to 90%.
The leading causes of death in patients with myocardial infarction include pump failure, life-threatening arrhythmias related to pump failure, or cardiac rupture—all clearly consequences of extensive myocardial necrosis. The extent of myocardial necrosis is the most critical determinant of patient prognosis. The most effective strategy to limit myocardial necrosis is early restoration of coronary blood flow.
If coronary artery patency can be restored early in the course of acute myocardial infarction, thereby reperfusing the ischemic myocardium adequately, further expansion of the infarct area can be prevented. We hope this information proves helpful to you!
