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[Comment] Intravenous fibrinolytics in STEMI: a 25-year perspective

Heart disease remains the number one cause of mortality and morbidity across most of the world.1 Although rates of acute myocardial infarction have fallen in high-income countries, mostly as a consequence of improved lifestyle modifications and continued evolution of risk factor modification,2 acute myocardial infarction remains the most important driver of cardiac mortality. The cornerstones of therapy for acute myocardial infarction have been based on the open-artery hypothesis.3 Previous experimental animal models have shown the initiation of myocardial cell death early after ligation of an epicardial coronary artery.