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The role of thrombolytic therapy has evolved since the discovery of the first lytic agent, streptokinase, in 1931. Since then, there have been several agents developed for specific areas of clot and some that have been forcibly adapted for use outside of their intended scope. Traditional use for thrombolytic therapy included acute MI, PE, and DVT. We have adapted thrombolytic therapy to treat acute occlusions of peripheral bypass grafts, dialysis fistula and grafts, venous access devices, and nonhemorrhagic stroke. Even newer uses are for fibrin sheaths around chest tubes. This presentation reviewed the history of the development of thrombolytic therapy, its uses in the coronaries and peripheral vasculature, the various agents that can be used, and the events of the mid-1990s that changed the practice in IR, NIR, and cardiac cath labs across the nation. This presentation allowed the participants to understand the role of each agent in thrombolytic therapy for each indication. They were able to better understand the roles of streptokinase, urokinase, and alteplase in acute MI, PE, DVT, and stroke. The participants have an understanding of the patient care associated with each clinical indication based on evidence-based medicine. The participants were also able to understand the difference in dosing each medication and the financial cost of each medication when treating clots at standard doses for each agent used. In addition, the participants were aware of the clients who were not having their clot treated adequately.

Background: Coronary artery diseases are one of the major challenges faced by cardiologists. Control of certain risk factors for CAD is associated with decrease in mortality and morbidity from myocardial infarction and unstable angina. So, identification and taking appropriate measures for primary and secondary prevention of such risk factors is, therefore, of great importance. This retrospective study was carried at the newly set up cath lab in Dhaka Medical college. Materials and Methods: Total 228 consecutive case undergone diagnostic coronary angiogram from 10th January 2007 to31st January 2009 out of which 194(80%) were male and 34 (20%) were female. In both sexes most of the patients were between 41 to 60 years of age. Risk factors of the patients were evaluated. Results: In females commonest risk factor was Diabetes (58.8%) followed by dyslipidaemia (35.3%). In males commonest risk factor was hypertension (30.9%) followed by smoking (29.9%) and diabetes (28.3%). In males 44.3% patients presented with acute myocardial infarction followed by stable angina (43.3%); but in females stable angina was the commonest presentation (50.0%) followed by myocardial infarction (38.2%).CAG findings revealed that in males 33.5% had double vessel disease 26.8% followed by single vessel 26.8% and multivessel disease 25.3%. In females normal CAG was found in 35.5% followed by double vessel 23.5%, multivessel 20.6% and single vessel 20.6%. On the basis of CAG findings; in males 41.8% patients were recommended for CABG, followed by PTCA & stenting 26.3% and medical therapy 30.0%; where as in females 55.9% were recommended for medical therapy , followed by CABG 32.4% and PTCA & stenting11.8%. Conclusion: The commonest presentation of CAD was 4th and 5th decades in both sexes. Diabetes and dyslipidaemia were more common in females whereas hypertension and smoking were more common in males. Myocardial infarction and stable angina were most common presentation in both sexes though in males myocardial infarction was more common. In males the angiographic severity of CAD was more and they were more subjected for CABG in comparison to females. Key words: Risk factors; Coronary angiography. DOI: http://dx.doi.org/10.3329/cardio.v3i2.9179 Cardiovasc. J. 2011; 3(2): 122-125