Advantage of Prehospital Thrombolysis in Acute Coronary Syndrome

The review describes the features of thrombolytic therapy in patients with acute myocardial infarction in detail. Thrombolytic therapy helps to reduce 30-day mortality in myocardial infarction from 17-18% to 5-8%. The issues of the optimal period of thrombolysis from the onset of the clinical manifestations of a heart attack, alternative methods for restoring coronary blood flow, indications and contraindications, complications and side effects, and methods for evaluating the effectiveness of thrombolysis are highlighted. The main fibrin-selective and fibrin-non-selective fibrinolytic drugs: streptokinase, alteplase, tenecteplase are listed. The results of large randomized clinical trials on fibrinolytic therapy of myocardial infarction are presented. The possibilities of increasing the effectiveness and safety of fibrinolytics by combining them with acetylsalicylic acid and heparins are discussed.