Antiplatelet Aggregant Agents and Thrombolytic Compounds in Myocardial Infarction: Current Status

ON MANY FRONTS, both prophylactic and therapeutic, major efforts have been or are about to be undertaken to decrease what some have termed the "epidemic" of coronary artery disease and acute myocardial infarction in our society. The difficulties confronting the clinical investigator who wishes to mount a meaningful therapeutic attack on this problem are great and stem from several sources. Mortality Rate Variations. Institutional mortality rates vary from 10 to 45% among patients hospitalized with acute myocardial infarction. The therapy to be evaluated thus may be significantly affected by the nature of the population tested, as reflected by its mortality rate, and the results obtained may not be applicable to apparently comparable populations in adjacent hospitals or in institutions in other cities or countries. Such basic differences in populations are widened still further when investigators increase the selectivity of their study populations by establishing different diagnostic or other clinical criteria for the inclusion or exclusion from the study of patients purported to have acute myocardial infarction and by employing nonstandard treatment criteria for complications such as arrhythmias and heart block.