Acute myocardial infarction is myocardial necrosis caused by acute, persistent ischemia and hypoxia in the coronary arteries. The coronary arteries are distributed on the surface of the heart and are the arteries that supply blood to the heart. If blood supply is not restored in a timely manner, it can affect the normal functioning of the heart and the whole body, and even lead to death in severe cases.

In 2010, the number of people with acute myocardial infarction in China reached 8.1 million, with about 1.0 million new cases each year. The incidence of myocardial infarction is closely related to the "three highs", alcohol drinking, and smoking. The incidence of myocardial infarction is mainly concentrated in people over 55 years old. However, the incidence of myocardial infarction in young people is also increasing year by year.

The mortality of acute myocardial infarction in China is generally on the rise. From 2002 to 2017, the mortality in urban areas increased from 16.46/100,000 to 58.90/100,000, and that in rural areas increased even more, from 12/100,000 to 76.04/100,000, a 5.3-fold increase. In the future, primary ares will be an essential battleground for myocardial infarction prevention and treatment.

Clinically, acute myocardial infarction usually has symptoms of severe and persistent retrosternal pain, which cannot be completely relieved by rest and nitrate drugs, accompanied by increased serum myocardial enzyme activity and progressive ECG changes, which can be complicated by arrhythmia, shock, or heart failure, and can often be life-threatening. For the treatment of myocardial infarction, we should keep in mind that "time is the myocardium, time is life". Myocardium starts to necrotize in about 30 minutes after vascular occlusion and completely necrosis in about 6-8 hours. The earlier the occluded blood vessel is opened during this period, the more myocardium will be survived. Therefore, immediately call 120 after myocardial infarction, and choose the fastest way to open blood vessels for rescue under the guidance of a doctor.

For patients with acute myocardial infarction, percutaneous coronary intervention (PCI) is an effective method to restore myocardial reperfusion. However, it is difficult to be promoted in many primary hospitals in China due to the limitations of medical conditions, geographic location, and technical capabilities of the hospitals where patients visit. Based on our national situation and the current situation of acute myocardial infarction treatment, early thrombolysis combined with transport PCI is the preferred strategy for most patients who cannot be treated with direct PCI within 120 minutes.

Thrombolytic therapy is a biochemical way to dissolve thrombus and open occluded blood vessels, which can be achieved by intravenous injection, regardless of location and environment, with the advantages of rapid, easy, and simple operation. Early thrombolysis combined with transfer PCI can open the infarcted vessel as early as possible, expanding the treatment time window and achieving the best patient efficacy.

Thrombolytic drugs include specific and non-specific ones. The former has a selective effect on fibrin, less effect on systemic fibrinolytic activity, a low risk of hemorrhage, and a higher rate of vascular recanalization. It is the first choice for thrombolysis in acute myocardial infarction. rhTNK-tPA is the latest generation of specific thrombolytic drugs independently developed in China. The clinical study data shows that the thrombus patency rate of rhTNK-tPA  is as high as 83%, which is significantly better than the imported control drugs. It is easy to use and is the only thrombolytic drug that can be injected intravenously in a single dose, with 5-10 seconds for fast vascular recanalization.