Prospects in antithrombotic therapy

Currently there is an increasing awareness of the magnitude and scope of the problem of thrombosis; renewed interest in this lesion also has been spurred by better appreciation of the limitations inherent in the use of the available anticoagulant agents as well as developments in new forms of antithrombotic therapy. Surprisingly, concern over coronary artery thrombosis as a proximate event precipitating acute myocardial infarction has not received the attention it deserves even though the most recent studies indicate that a thrombotic episode occurred in approximately 90 percent of patients who died after a classic acute myocardial infarction. This article briefly reviews (1) current concepts of the pathogenesis of acute coronary thrombosis; (2) the basis for, and developments in, the use of anti-platelet aggregating agents for prophylactic purposes; and (3) prospects for the application of thrombolytic agents to the treatment of acute myocardial infarction.