Interventional strategies for managing acute myocardial infarction.

The management of acute myocardial infarction has evolved greatly with the development of interventional cardiology and thrombolytic therapy. Interventional strategies in the setting of thrombolytic therapy include immediate, delayed, and elective PTCA. Randomized trials suggest no benefit to these approaches; however, primary PTCA without adjunctive lytics when compared to lytic therapy alone may improve both survival and costs. Newer catheter-based technology may also enhance outcomes in patients with acute myocardial infarction.