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Adjuncts to Thrombolysis for Myocardial Reperfusion

Jeffrey J. Popma, MD; and Eric J. Topol, MD
[+] Article, Author, and Disclosure Information

Requests for Reprints: Eric J. Topol, MD, Department of Cardiology, One Clinic Center, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195.

Current Author Addresses: Dr. Popma: Washington Heart Center, 110 Irving Street, NW, Room 4B/14, Washington, DC 20010.

Dr. Topol: Department of Cardiology, One Clinic Center, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195.

© 1991 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1991;115(1):34-44. doi:10.7326/0003-4819-115-1-34
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Objective: To discuss adjunctive pharmacologic agents for acute myocardial infarction, to critique their initial effects in clinical trials, and to review their potential for improving the clinical conditions of patients with acute myocardial infarction.

Data Sources: Relevant studies reported from January 1985 to December 1990 were identified through a MEDLINE search of the English-language literature and through a manual search of the bibliographies of all identified articles.

Study Selection: Peer-reviewed experimental and clinical studies evaluating the role of pharmacologic adjuncts to thrombolytic therapy in experimental models of coronary occlusion and clinical trials of patients with acute myocardial infarction were selected for review.

Data Extraction and Synthesis: The data presented were abstracted by the investigators. Differences with a univariate P value of less than 0.05 were considered to be statistically significant.

Conclusions: Current clinical data suggest that adjunctive pharmacologic therapy to thrombolytic agents should include aspirin, at least 160 mg administered as soon as possible after the onset of symptoms; intravenous heparin; and, in selected patients without contraindications, intravenous beta-blockading agents.





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