Why the study?
Does facilitated PCI or a pharmaco-invasive approach offer advantages over primary PCI in patients with STEMI?
Does facilitated PCI or a pharmaco-invasive approach offer advantages over primary PCI in patients with STEMI?
While facilitated PCI offers no advantage over primary PCI, a pharmaco-invasive strategy remains a viable option for STEMI patients presenting to non-PCI capable centers.
Answers are grounded in this paper and cite their sources.
May discourage facilitated PCI; leaves open pharmaco-invasive role in non-PCI centers for prospective trials.
Primary percutaneous coronary intervention (PCI) is the preferred reperfusion method in patients with STelevation myocardial infarction (STEMI), when performed in a timely manner and by skilled operators. However, this strategy has shown to be limited in environments with lack of PCI facilities and delay in the first medical contact-toballoon time for logistic reasons. Pretreatment with fibrinolysis and/or glycoprotein IIb/IIIa inhibitors before PCI has the potential to provide early pharmacologic reperfusion before definitive PCI in STEMI patients. However, current data suggest that facilitated PCI does not offer any advantage over primary PCI. Conversely, a role for pharmacoinvasive recanalization, defined as pharmacological reperfusion followed by rapid transfer for routine delayed coronary angiography and PCI may still be considered in centers without on-site PCI capability.
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Capodanno et al. (2012) studied this question.
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