Primary angioplasty reduces short-term mortality and nonfatal reinfarction compared to thrombolytic therapy for the treatment of acute myocardial infarction.
Does primary angioplasty reduce short-term mortality and nonfatal reinfarction in patients with acute myocardial infarction compared to thrombolytic therapy?
This review advocates for the routine use of primary coronary angioplasty over thrombolysis for acute myocardial infarction due to reduced short-term mortality and reinfarction.
The use of thrombolytic therapy has been widely accepted for the treatment of acute myocardial infarction. Despite improving mortality, thrombolytic therapy may be contraindicated in many patients presenting with myocardial infarction and is associated with a small, yet significant risk of hemorrhagic sequelae. This article outlines the rationale behind reperfusion therapy, the use of pharmacological thrombolysis and the role of adjunctive angioplasty. The potential advantages of a therapeutic strategy of primary angioplasty, instead of thrombolysis, are discussed. These include anatomical definition, risk stratification, reduced recurrent ischemia, enhanced coronary perfusion and improved coronary patency. The randomized trials in which primary angioplasty and thrombolytic therapy were compared are reviewed. We conclude that angioplasty results in a reduction of short-term mortality and nonfatal reinfarction and therefore advocate the routine use of coronary angioplasty as a primary reperfusion strategy for acute myocardial infarction. The potential limitations of primary angioplasty in the community hospital setting are discussed. Finally, we examine the roles of adjunctive mechanical (e.g. stents) and pharmacological (e.g. Abciximab) means of further enhancing outcomes after primary angioplasty.
Juergens et al. (Sat,) conducted a review in Acute Myocardial Infarction. Primary angioplasty vs. Thrombolytic therapy was evaluated on Short-term mortality and nonfatal reinfarction. Primary angioplasty reduces short-term mortality and nonfatal reinfarction compared to thrombolytic therapy for the treatment of acute myocardial infarction.