Newer interventions in myocardial infarction: do they make a difference?

Preventive aspects of coronary artery disease have made substantial advances in recent years, decreasing the incidence of coronary artery disease in Western countries. In addition to that there has been an initial drop from an in-hospital mortality of 35% to approximately 12% in the early 1960s with the establishment of coronary care units and cardiopulmonary resuscitation with defibrillation. Further to that, in recent years, it has been conclusively shown that there would be a further 20% decrease in mortality and improvement in morbidity in acute myocardial infarcts in patients treated with thrombolytic agents who present themselves within four hours of the onset of their symptoms and who are under 65 years of age. This would decrease the in-hospital mortality to approximately nine percent.