An Early and Complete Reperfusion Strategy for Acute Myocardial Infarction Using Fibrinolysis and Subsequent Transluminal Therapy. The FAST Trial.

195 patients with acute myocardial infarction (AMI) presenting after 30 min of continuous symptoms but within 12 hours of onset, with ST-segment elevation (≥0.1mV in 2 limb leads or ≥0.2mV in precordial leads) or bundle branch block. Mean age ~59, ~16% female, based in Japan. Excluded patients ≥75 years, history of stroke/CNS damage, prior MI, prior PCI/CABG, active bleeding, recent trauma/surgery, and severe hypertension (SBP >180 or DBP >110 mmHg).

Intravenous thrombolysis alone (patients achieving TIMI-3 flow at initial angiography after receiving optimal dose of thrombolytic agent and aspirin 81-162 mg)

Thrombolysis plus adjuvant percutaneous coronary intervention (patients presenting with TIMI-0, 1, or 2 flow at initial angiography who immediately underwent adjuvant PCI or intracoronary prourokinase)

30-day mortality and degree of myocardial damage based on the amount of creatine kinase-MB (CK-MB) released and peak cardiac troponin T levelssurrogate