Key result
Direct PTCA is more efficacious than thrombolysis for restoring blood flow in acute myocardial infarction, and additional stenting reduces the need for target lesion revascularization.
Why the study?
Early, complete, and sustained restoration of blood flow in acute myocardial infarction improves survival, but the comparative effects of PTCA and thrombolysis on reperfusion quality and early complications require clarification.
In acute myocardial infarction, early, complete, and sustained restoration of blood flow in the occluded coronary artery can salvage myocardium at risk and improve survival. Randomized trials (1) as well as large registries (2,3) have shown that direct percutaneous transluminal coronary angioplasty (PTCA) is more efficacious in achieving this goal than thrombolysis. Additional placement of a stent improves long-term clinical outcome by reducing the need for target lesion revascularization but has no beneficial effect on the quality of reperfusion or the risk of early complications, such as death and reinfarction (4–6).
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Franz–Josef Neumann (2003) conducted a review in acute myocardial infarction. Glycoprotein IIb/IIIa Receptor Blockade / PTCA vs. thrombolysis was evaluated. Direct PTCA is more efficacious than thrombolysis for restoring blood flow in acute myocardial infarction, and additional stenting reduces the need for target lesion revascularization.
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