Patient selection issues in the use of thrombolytic therapy in patients with acute myocardial infarction.

The proportion of patients with acute myocardial infarction who are currently being treated with thrombolytic therapy is small. It is not readily apparent why the use of thrombolytic therapy is not more widespread. Several factors have been raised to explain the limited use of thrombolytic therapy, including patient age and late presentation after symptom onset. Recent data suggests that the benefits of thrombolytic therapy should be extended to these selected high-risk subgroups. A philosophy of finding a reason not to treat with thrombolytic therapy should be adopted by all practicing clinical cardiologists.