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The primary goal of thrombolytic therapy for acute coronary syndrome (ACS) is to achieve myocardial reperfusion. Thrombolytic agents are designed to dissolve blood clots that obstruct blood flow to the heart muscle, which can lead to ischemia and subsequent damage if not addressed timely. By restoring blood flow, thrombolytic therapy helps minimize heart muscle damage, allowing for better preservation of myocardial function.

While chest pain relief may occur as a consequence of successful reperfusion, it is not the primary aim. The main focus lies in restoring adequate blood supply to the myocardial tissue, as this directly affects the patient's overall prognosis and recovery. Troponin release is a marker used to assess myocardial injury rather than the goal of the therapy itself. Lastly, while managing ectopy may be a consideration in the overall treatment of a patient with ACS, it is not the central objective of thrombolytic therapy. Thus, myocardial reperfusion stands as the fundamental target during treatment with thrombolytics in ACS situations.