The pharmaco-invasive approach to STEMI: when should fibrinolytic-treated patients go to the "cath lab"?

Abstract:

:Although primary percutaneous coronary intervention (PCI) in clinical trials has lower rates of reinfarction, stroke and mortality than fibrinolytic therapy, because of system delays in routine practice, field triage and prehospital administration of fibrinolytic therapy may lead to similar clinical outcomes, especially in those patients who present in the first 2 h after symptom onset. Necessary for these outcomes is the liberal use of both rescue PCI and in-hospital revascularisation. Non-invasive prediction of failed reperfusion may be enhanced by the use of ST recovery, patient characteristics and troponin T levels, measured by point-of-care assays. This review focuses on the timing of, and indications for, an invasive strategy after fibrinolytic therapy, including that for failed pharmacological reperfusion.

journal_name

Postgrad Med J

authors

Edmond JJ,Juergens CP,French JK

doi

10.1136/hrt.2007.137182

subject

Has Abstract

pub_date

2009-06-01 00:00:00

pages

331-4

issue

1004

eissn

0032-5473

issn

1469-0756

pii

85/1004/331

journal_volume

85

pub_type

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