Author/Editor		Sinkovič, Andreja; Svenšek, Franci
Title		Fibrinolitična terapija akutnega miokardnega infarkta
Translated title		Fibrinolytic therapy in acute myocardial infarction
Type		članek
Source		In: Hojs R, Krajnc I, Pahor A, et al, editors. Zbornik predavanj in praktikum Iz prakse za prakso z mednarodno udeležbo. 13. srečanje internistov in zdravnikov splošne medicine; 2002 maj 10-11; Maribor. Maribor: Splošna bolnišnica Maribor,
Publication year		2002
Volume		str. 165-79
Language		slo
Abstract		Background. Acute myocardial infarction (AMI) is the consequence of thrombotic occlusion at the site of deteriorated atherosclerotic plaque in 90% of patients. It can be dissolved by fibrinolytic agents, resulting in reperfusion of the jeopardized myocardium in 30% to 70% of cases. The consequence is decreased incidence of heart failure and sudden death, and improved survival after AMI. Early fibrinolytic treatment is most effective. If the inclusion criteria are met, streptokinase (STK) or alteplase (rtPA) are most frequently used. Alteplase is most effective in the first 6 hours of anterior AMI in younger patients, while STK is effective even up to 12 hours after the onset of AMI. This holds true even in older patients due to the lowest incidence of intracerebral bleeding. Intracerebral haemorrhage and reinfarctions are most important side effects. To prevent intracerebral bleeding, it is important to exclude patients with contraindications for fibrinolytic therapy. At present, new fibrinolytic agents are being tested in clinical trials (tenecteplase), which are even more promising in decreasing mortality, can be administered as i.v. bolus and/or combined with various antithrombotic agents, even during transport. Conclusions. Reperfusion achieved by fibrinolytic therapy significantly improves survival, decreases the rate of heart failure and sudden death in patients with AMI, especially when administered early.
Descriptors		MYOCARDIAL INFARCTION FIBRINOLYTIC AGENTS THROMBOSIS