Streptokinase, APSAC, and rtPA clearly reduce mortality in acute @entity583 . rtPA is definitely superior at recanalization; it does it faster and more effectively in the first 1-2 h after infusion. There is no evidence that it causes less @entity548 , but rather that the proneness to @entity548 might be a little higher. rtPA is expensive. Therefore, on the whole, physicians in the United Kingdom mainly use streptokinase and some APSAC. rtPA is probably the best agent for second-time use within 6-12 months of the first use of streptokinase or APSAC, when antibodies may limit the effectiveness of these agents. @entity117 is clearly useful, and one should remember to use it long term in any @entity1 who has had a vascular event. It should not be used for primary prevention except where there is a clear vascular risk. For secondary prevention, it is very effective. Intravenous beta-blockers should be considered for less ill @entity1 , who amount to about 50% of all @entity1 admitted. Beta-blocker treatment reduces @entity7086 and should be used in conjunction with thrombolysis and continued long term in @entity1 without contraindications. It also has proven antiarrhythmic benefit ( @entity944 ). Anticoagulants are promising but yet to be proven. @entity3362 may have a place in the acute therapy of @entity583 , but @entity460 blockers and @entity3303 are definitely not suited for routine use. @entity3303 should generally be used only in @entity1 who already have @entity2224 or severe or symptomatic @entity943 . Finally, before getting too enthusiastic, one should remember that this overview deals only with those @entity1 who reach the hospital alive. There is a huge number of @entity1 at least equal to those admitted who die before reaching medical help. They have to be prevented from getting a @entity583 . Therefore, along with better treatment, we need to focus on prevention, with arguments against smoking, excess weight, and in favor of more exercise. These arguments are still very important.

Medical interventions in acute XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'people'] @entity7086 :: ('MESH:D006341', 'Disease') :: ['cardiac rupture'] @entity548 :: ('MESH:D006470', 'Disease') :: ['bleeding'] @entity944 :: ('MESH:D003645', 'Disease') :: ['sudden death'] @entity3362 :: ('MESH:D009566', 'Chemical') :: ['Nitrates'] @entity117 :: ('MESH:D001241', 'Chemical') :: ['Aspirin'] @entity3303 :: ('MESH:D008012', 'Chemical') :: ['Lidocaine', 'lidocaine'] @entity2224 :: ('MESH:D014693', 'Disease') :: ['ventricular fibrillation'] @entity460 :: ('MESH:D002118', 'Chemical') :: ['calcium'] @entity583 :: ('MESH:D009203', 'Disease') :: ['myocardial infarction'] @entity943 :: ('MESH:D001145', 'Disease') :: ['ventricular arrhythmia']
@entity583 :: (MESH:D009203,Disease) :: ['myocardial infarction']
