This paper reevaluates the optimal timing of thrombolytic treatment in acute myocardial infarction (AMI), focusing on whether very early treatment (within 2-3 hours of symptom onset) can provide additional benefits. The authors analyzed data from 22 randomized trials involving over 50,000 patients to assess the relationship between treatment delay and short-term mortality (up to 35 days). They found that the benefit of fibrinolytic therapy was significantly higher in patients treated within 2 hours compared to those treated later, with a proportional mortality reduction of 44% vs 20% (p=0.001). The non-linear regression model fit the data better than a linear model, suggesting that the benefit decreases more rapidly after 2 hours. The authors conclude that very early thrombolytic treatment within the first 2-3 hours of symptom onset can significantly improve outcomes, supporting the concept of a "first golden hour" for AMI treatment. They emphasize the importance of reducing treatment delay and improving public awareness to enhance survival rates in patients with suspected AMI.This paper reevaluates the optimal timing of thrombolytic treatment in acute myocardial infarction (AMI), focusing on whether very early treatment (within 2-3 hours of symptom onset) can provide additional benefits. The authors analyzed data from 22 randomized trials involving over 50,000 patients to assess the relationship between treatment delay and short-term mortality (up to 35 days). They found that the benefit of fibrinolytic therapy was significantly higher in patients treated within 2 hours compared to those treated later, with a proportional mortality reduction of 44% vs 20% (p=0.001). The non-linear regression model fit the data better than a linear model, suggesting that the benefit decreases more rapidly after 2 hours. The authors conclude that very early thrombolytic treatment within the first 2-3 hours of symptom onset can significantly improve outcomes, supporting the concept of a "first golden hour" for AMI treatment. They emphasize the importance of reducing treatment delay and improving public awareness to enhance survival rates in patients with suspected AMI.