Myocardial Infarction and Coronary Reperfusion

Myocardial infarction in most patients is related to coronary occlusion at the site of a ruptured plaque with resulting thrombus formation. The thrombus is comprised of platelets and fibrin. Coronary reperfusion has definitely been shown to be beneficial in terms of myocardial salvage and resultant mortality. The most benefit is obtained if reperfusion is accomplished within 6 hours and preferably within 2 hours. From thrombolytic trials, there was a 25% reduction in mortality if therapy was initiated within 6 hours and a 16% reduction if therapy was initiated within 7-12 hours.