What an interventional cardiologist should know about the pharmacological treatment of acute myocardial infarction.

The treatment of acute myocardial infarction consists of pain and anxiety relief, anti-ischaemic treatment and antithrombotic therapy. Due to its bleeding complications and, in some cases, procoagulant effects, antithrombotic therapy has consequences for coronary procedures in the setting of acute myocardial infarction. Antiplatelet therapy has no procoagulant effects, and its bleeding complications can easily be managed. Antithrombin therapy has rebound effects, for which no clear solution is available. Thrombolytic therapy has also procoagulant effects, which may interfere with coronary procedures in the early hours of acute myocardial infarction. Heparin may counteract the thrombolysis-induced thrombin generation, but has an unpredictable effect. Postprocedural therapy after angioplasty in the setting of acute myocardial infarction should consist of antiplatelet therapy.