Why the study?
Does rescue PCI with stents and antiplatelet therapy reduce cardiovascular mortality and morbidity in patients with acute ST-elevation myocardial infarction and inadequate reperfusion after fibrinolysis compared with conservative therapy?
Does rescue PCI with stents and antiplatelet therapy reduce cardiovascular mortality and morbidity in patients with acute ST-elevation myocardial infarction and inadequate reperfusion after fibrinolysis compared with conservative therapy?
Rescue PCI with stents and antiplatelet therapy is a safe and effective strategy that decreases cardiovascular mortality and morbidity compared to conservative therapy in STEMI patients with failed fibrinolysis.
May support rescue PCI after failed fibrinolysis; hypothesis-generating and leaves open need for randomized confirmation.
Coronary reperfusion for acute ST-elevation myocardial infarction can be accomplished with fibrinolytic therapy or with percutaneous coronary intervention (PCI). Primary PCI provides more effective and sustained early reperfusion than fibrinolytic therapy, but is only available in a minority of hospitals worldwide. There is a lack of a definite method for identification of patients who have inadequate reperfusion after fibrinolysis. Transfer of patients after fibrinolysis for diagnostic angiography and possible rescue therapy is safe and feasible. Rescue PCI with the use of stents and antiplatelet therapy decreases cardiovascular mortality and morbidity compared with conservative therapy. Increasing use of primary PCI and forming networks to transfer patients to centers that offer primary PCI may decrease the need for rescue therapy in the future.
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Tadros et al. (2005) studied this question.
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