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Acute Coronary Care in the Thrombolytic Era

Peter T. Kuo, MD
JAMA. 1988;260(19):2932. doi:10.1001/jama.1988.03410190180048.
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In the early 1970s, the approach to acute coronary artery occlusion and its complications included, primarily, measures to reduce myocardial oxygen demand and to block catecholamine release. The recent advent of thrombolytic therapy has opened a new vista of acute coronary care. Aggressive intervention in the acute coronary event with early thrombolytic therapy, followed by balloon angioplasty and bypass surgery when needed, can lead to preservation or revival of viable stunned myocardium and improvement of cardiac function. Drs Califf, Mark, and Wagner and 66 other contributors to this book have provided readers with the latest information on this vitally important, rapidly evolving area of health care.

Among the diverse mechanisms involved in the acute interruption of coronary blood flow, plaque fissuring is considered to be a predominating factor. Minor plaque fissuring can promote atheromatous growth, while a major fissure would result in thrombotic occlusion. Thus, study of the molecular physiological


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