May 16, 1990

Cardiovascular Disease

JAMA. 1990;263(19):2629-2631. doi:10.1001/jama.1990.03440190085044

The results of multiple clinical trials performed during the 1980s make it clear in 1990 that thrombolytic therapy should be considered for all patients with evolving myocardial infarction.

The major trials that have been completed or that are in progress include the following: the Thrombolysis in Myocardial Infarction (TIMI) Trial Phase I published in 19851 found that tissue plasminogen activator (TPA) was superior to streptokinase in dissolving coronary artery thrombi. The AIMS study2 reported that the recently Food and Drug Administration—approved thrombolytic agent anisoylated streptokinase plasminogen activator complex can be given as a bolus with reperfusion results similar to those achieved with streptokinase. The TIMI Trial Phase II A published in November 19883 showed that, contrary to prevailing views, there was no advantage to performing angioplasty immediately after thrombolytic therapy over performing the procedure 18 to 24 hours later. The Second International Study of Infarct Survival4