[Thrombolysis and myocardial infarct].

Thrombolytic therapy in acute myocardial infarction is able to recanalize thrombotic occluded infarct arteries in about 35 to 90%. The results depend on the thrombolytic agent and the route of administration (i.c., i.v.). Successful recanalization causes a reduction of hospital- and one year mortality and reduction of the infarct size in a close correlation to duration of ischemic pain at the beginning of thrombolysis. Significant residual stenoses persist in about 80 to 90% after successful reperfusion. In these patients, PTCA can be performed with high success rates and with a low incidence of complications. Successful PTCA is associated with a reduction of reinfarction and further improvement of left ventricular function. Thus, the value of thrombolysis in acute myocardial infarction in patients with pain duration shorter than 3 to 4 hours is established. The value and optimal point of time for performing PTCA after thrombolysis remains to be defined.