Key result
Nonspecific plasminogen activators improve rescue angioplasty success and cut reocclusion ~59% versus specific agents.
Why the study?
What is the optimal timing and strategy for coronary angiography after intravenous thrombolytic therapy in acute myocardial infarction?
Meta-Analysis
Yes
What is the optimal timing and strategy for coronary angiography after intravenous thrombolytic therapy in acute myocardial infarction?
Absolute Event Rate: 86% vs 75%
p-value: p=0.03
Following thrombolytic therapy for acute myocardial infarction, either selective or routine angiography is acceptable for uncomplicated patients, while emergency angiography is primarily for primary or rescue angioplasty.
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Nonspecific plasminogen activators may improve rescue angioplasty outcomes after thrombolysis; extends randomized evidence guiding agent selection in acute MI.
Topol et al. (1991) conducted a meta-analysis in Acute Myocardial Infarction. Nonspecific plasminogen activators vs. Relatively specific agents was evaluated on Technical success of rescue coronary angioplasty (p=0.03). Rescue coronary angioplasty after thrombolysis had higher technical success (86% vs 75%, P=0.03) and lower reocclusion (10.9% vs 26.8%, P<0.001) with nonspecific vs specific plasminogen activators.
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