ABSTRACT
With the knowledge that acute thrombotic occlusion of a major epicardial coronary artery is the most common pathophysiological mechanism in acute ST-segment elevation myocardial infarction, fibrinolytic therapy has become standard therapy. It is easy to administer and, in contrast to mechanical reperfusion therapy by primary angioplasty, it is widely available. The costs are moderate and the benefit of in-hospital treatment is important: approximately 20 lives saved per 1000 treated patients.1
Especially in very early, and preferably, pre-hospital treatment an additional 18 lives per 1000 can be saved.2 Outcome after fibrinolytic therapy can be improved by adjuvant antiplatelet therapy, such as aspirin, and very likely, also by anticoagulant treatment.3
