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Interfering with healing: the benefits of intervention during acute myocardial infarction
K S Channer, P J PughDepartment of
Cardiology, Royal Hallamshire Hospital, Glossop Road, Sheffield
S10 2JF, UK
Correspondence to: Dr Channer kevin.channer@csuh.nhs.uk
Accepted 20 February
2001
| The first 150 words of the full text of this article appear below. |
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Introduction |
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Early thrombolysis and low dose aspirin reduce mortality from myocardial infarction by about 25%,1 and in combination the two drugs have an additive effect, reducing mortality by 45%.2 This reduction is maintained for up to 12 years after the event and the survival curves of placebo treated patients are parallel to those of the treated groups, showing that there is no additional long term effect of active treatment.2-4 The benefit is simply a reduced case fatality rate at the time of the event. In this paper we discuss a hypothetical explanation for these observational data, based on current understanding of the pathophysiological processes during infarction and the effects of reperfusion therapy.
Although postmortem examinations are limited, there is no single cause
for the observed benefit but a general reduction in mortality and
complications across the board.5-7 That infarct size is
reduced by thrombolytic treatment is seen by cumulative measurements of
cardiac
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