Coronary arteries become narrowed when cholesterol builds up on the inside wall of the artery. If a clot forms where the artery is narrowed, then the artery becomes completely blocked, causing angina or a heart attack. Thrombolytic medications are powerful blood thinners that can break down new blood clots in the coronary arteries.

Examples:

• Thrombolytic therapy
• Cardiac catheterization
• Coronary angiogram

Thrombolytic medications used to treat myocardial infarction include:

• Alteplase, (t-PA, Activase)
• Reteplase (Retavase)
• Anistreplase (Eminase)
• APSAC
• Streptokinase (Kabikinase, Streptase)
• Tissue plasminogen activator
• Tenecteplase (TNKase)
• Urokinase

Severe bleeding is the major complication of the thrombolytic medications. Overall, they reduce the risk of death from a myocardial infarction.

Conditions in which thrombolytics are not used include:

• Internal bleeding:
• Gastrointestinal bleeding
• Hematuria (blood in the urine)
• Brain tumor
• Brain or spinal surgery in the past 2 months
• Recent stroke in the past 2 months
• Severe, uncontrolled hypertension