Mortality at 1 Year With Combination Platelet Glycoprotein IIb/IIIa Inhibition and Reduced-Dose Fibrinolytic Therapy vs Conventional Fibrinolytic Therapy for Acute Myocardial Infarction

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Abstract
Myocardial reperfusion remains the foundation of early management of acute myocardial infarction (MI). Although demonstrated to improve survival in this setting,1,2 contemporary pharmacologic reperfusion therapies appear to have reached a plateau in mortality reduction.3,4 Interest has turned to the development of adjunctive strategies that may enhance the effectiveness of fibrinolytic agents. Pilot angiographic studies among patients with acute MI indicated that potent inhibition of platelet aggregation with glycoprotein IIb/IIIa receptor antagonists in combination with reduced doses of fibrinolytic agents may increase rates of epicardial infarct vessel patency and improve the quality of microvascular tissue reperfusion relative to conventional plasminogen activator therapy.5-7