Reperfusion therapy for acute myocardial infarction: historical context and future promise

Reperfusion therapy for acute myocardial infarction is a milestone achievement in 20th century cardiology, This article tracks this therapy from the discovery that coronary thrombosis is the cause of myocardial infarction. through the pre-clinical era when studies in dogs demonstrated the benefit of early reperfusion. Then came early clinical observations in the feasibility of coronary thrombolysis in patients. followed by the early placebo-controlled megatrials (GISSI-I and ISIS-2). which showed a Substantial mortality benefit. During the past decade there ha c been important refinements using ambulance-based therapy. new bolus thrombolytics, adjunctive glycoprotein inhibitors and percutaneous coronary intervention. (C) 2002 The European Society of Cardiology.