Coronary thrombolytic therapy: state of the art.

Ischemic heart disease remains a significant cause of morbidity and mortality in the United States. Thrombolytic therapy has given physicians the capability of limiting the amount of myocardial damage that occurs when there is an acute coronary artery thrombosis and resulting myocardial infarction. This review summarizes current concepts about action mechanisms of the major thrombolytic agents, the technique and clinical results of intracoronary thrombolytic therapy, intravenous vs intracoronary administration, postthrombolytic management of underlying coronary artery disease, new agents being developed, and directions for future investigations.