Therapies to limit infarct size. Timing, dosage, and effectiveness.

Rapid diagnosis of an evolving acute myocardial infarction and institution of thrombolytic therapy in appropriate patients can markedly decrease infarct size and thus reduce cardiovascular morbidity and mortality. Streptokinase (Kabikinase, Streptase) and recombinant tissue plasminogen activator (Activase) are both widely used, effective clot-dissolving agents. Patients who are not candidates for thrombolytic therapy can be treated with other methods, such as anticoagulant therapy, which can greatly reduce infarct size. Intravenous heparin, beta blockers, nitroglycerin, and aspirin have all been shown to limit infarct size, decrease mortality, or do both in patients with acute myocardial infarction.