Prehospital treatment with the thrombolytic tenecteplase [`Metalyse', `TNKase'] plus either enoxaparin sodium [`Lovenox'] or unfractionated heparin (UFH) is as effective as inhospital treatment in reducing ischaemic events in patients following acute ST elevation myocardial infarction (MI), according to results from the ASSENT (ASsessment of the Safety and Efficacy of New Thrombolytic regimens) 3 PLUS study. These data, presented in a latebreaker session at the 75th Annual Scientific Sessions of the American Heart Association (AHA) [Chicago, US; November 2002] indicated that administration of thrombolytic therapy prior to hospital admission reduced treatment delay by an average of 45 minutes, compared with inhospital treatment, and had comparable efficacy and tolerability. The combination of tenecteplase/enoxaparin was more effective than tenecteplase/UFH in patients aged < 75 years. Tenecteplase/enoxaparin also showed a trend towards superiority in the overall patient population, although this was offset by a higher mortality rate due to intracranial haemorrhage in patients aged > 75 years.