Fibrinogen Proteolysis and Coagulation System Activation during Thrombolytic Therapy

Thrombolytic treatment of patients with acute myocardial infarction is now well accepted as the treatment of choice in most settings (24). At this time most data has been accumulated with the use of streptokinase, and this drug has been convincingly demonstrated to reduce mortality (5). Reperfusion is achieved in 45–75% of patients, with direct intracoronary administration being slightly more effective than administration by the intravenous route (25). Some problems remain, bleeding is significant and rethrombosis continues to be an obstacle (7).