Role of the clinical laboratory in monitoring fibrinolytic therapy of acute myocardial infarction.

Thrombolytic therapy is rapidly becoming a routine part of the treatment of acute myocardial infarction. The clinical laboratory is often called upon to help monitor changes in the hemostatic system in these patients. This review will address laboratory monitoring of patients treated with the two most commonly used thrombolytic agents: streptokinase (SK) and recombinant tissue plasminogen activator (rt-PA). The fibrinolytic system and recent clinical trials are discussed. This is followed by a review of available assays and their place in therapeutic monitoring.