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Thrombotic occlusion of an epicardial coronary artery has been implicated as a potential mechanism involved in acute myocardial infarction since as early as 1910. In the search for pharmacological means to dissolve thrombi, the so called "thrombolytics" were developed. These agents target fibrin, the key element in clot formation, and are therefore more accurately referred to as "fibrinolytics". Large clinical trials confirmed the hypothesis that timely restoration of coronary patency had a notable impact on survival after ST elevation myocardial infarction, 20-30 lives saved per 1000 patients treated. With improvements in techniques and experience, mechanical reperfusion therapy has been proven to be even more beneficial than in-hospital initiated fibrinolytic therapy. Yet, pharmacological reperfusion therapy is more widely available, more easily applicable, and less dependent of institutional experience.