ABSTRACT
Acute ST-elevation myocardial infarction (STEMI) affects 30-50% of patients presenting with an acute coronary syndrome (ACS) and requires immediate reperfusion therapy. The benefits of such an intervention have been amply documented [1,2]. Beyond extending survival, it improves myocardial salvage, preserves an open artery as a source of collateral flow, and limits the danger of malignant arrhythmias. Fibrinolytic therapy has been studied extensively over the last two decades and has remained the mainstay of reperfusion therapy because of its universal and rapid availability. Chapter 9 reviews in detail the significant contributions to these goals of the first two generations of lytic agents, as well as their important limitations.
