Percutaneous Coronary Intervention After Successful Fibrinolytic Therapy for ST-Segment Elevation Myocardial Infarction

Buckley, Jeremy W.; Nallamothu, Brahmajee K.

doi:10.1016/j.jacc.2009.09.024

Cited by 4 publications

(3 citation statements)

References 16 publications

(10 reference statements)

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“…La TL -garantizada en el protocolo AUGE -es la estrategia más utilizada en el mundo, y constituye una alternativa por la que se puede optar en caso que un paciente no pueda ser tratado dentro de los primeros 60-90 minutos con APP. Una vez que los pacientes han sido tratados exitosamente con TL deben ser referidos dentro de las primeras 24 horas a un centro que cuente con hemodinamia para efectuar una Angioplastía Electiva (APE) con el objetivo de asegurar una permeabilidad coronaria estable en la arteria culpable del IAM [11][12][13][14] . Para aquellos pacientes en los que no se ha logrado una terapia de reperfusión oportuna -que en nuestro país alcanza hasta un 30% 10 -o en aquellos casos en los que la TL no ha sido exitosa, persistiendo síntomas o evidencias electrocardiográficas de isquemia a los 90 minutos de terminada la administración del trombolítico, la mejor opción terapéutica es la Angioplastía de Rescate (APR) 15 .…”

Section: Alternativas Para La Reperfusión Oportuna Y Exitosa: Combinaunclassified

Reperfusión fármaco-invasiva en el manejo del infarto agudo de miocardio en Chile: Un llamado a la acción

Sepúlveda

Corbalán

2019

Rev Chil Cardiol

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Section: Alternativas Para La Reperfusión Oportuna Y Exitosa: Combinaunclassified

Reperfusión fármaco-invasiva en el manejo del infarto agudo de miocardio en Chile: Un llamado a la acción

Sepúlveda

Corbalán

2019

Rev Chil Cardiol

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“…Second, on the basis of many recent studies, routine angiography, and PCI where appropriate, overrides a selective ischaemia‐driven invasive approach as the recommended management after thrombolysis 30 . ‐ 37 Importantly, these studies strongly indicate that angiography, with PCI if needed, is best performed within the first 24 hours 30 . ‐ 37 The well known difficulties in arranging prompt transport from one hospital to another make immediate admission to a PCI‐capable hospital preferable.…”

Section: Management Of Patients After Phtmentioning

confidence: 99%

“…‐ 37 Importantly, these studies strongly indicate that angiography, with PCI if needed, is best performed within the first 24 hours 30 . ‐ 37 The well known difficulties in arranging prompt transport from one hospital to another make immediate admission to a PCI‐capable hospital preferable. For these reasons, patients who have been treated with PHT should be taken to the nearest PCI‐capable hospital even when transport distances are long.…”

Section: Management Of Patients After Phtmentioning

confidence: 99%

Prehospital thrombolysis followed by early angiography and percutaneous coronary intervention where appropriate — an underused strategy for the management of STEMI

Harper

Lefkovits

2010

Medical Journal of Australia

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Prompt myocardial reperfusion, particularly if achieved within 2 hours of the onset of symptoms, improves outcomes in patients with ST‐elevation myocardial infarction (STEMI). Recent data suggest that ambulance‐administered prehospital thrombolysis, if given within 2 hours of the onset of STEMI, produces superior outcomes to primary percutaneous coronary intervention (PCI); if given within 4 hours, the outcomes are similar. For optimal results after thrombolysis, patients require angiography (and PCI where appropriate) within 24 hours of the event. These developments have major implications for the practice of cardiology and for the organisation of health services in Australia.

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As time goes by? The fallacy of thrombolysis in STEMI networks

Scheidt

Thilo

2011

Clin Res Cardiol

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Primary percutaneous coronary intervention (PPCI) is superior to thrombolysis (TL) as reperfusion therapy in ST-elevation myocardial infarction (STEMI). TL is a rapidly available, but semi-effective therapy (effective reperfusion in 50% of patients only), whereas PPCI is a potentially delayed, but highly effective therapy (effective reperfusion in >90%). Since TL loses its efficacy beyond 2-3 h after symptom onset, it is a significant reperfusion alternative to PPCI in early presenters only. The individual decision to treat an early presenter with PPCI or TL requires the evaluation of the time delay between potential start of TL or PPCI, the PCI-related delay (PRD). PRD is greatest, if TL is given in the prehospital setting. Until now, prehospital TL as the most rapidly available reperfusion strategy has failed to demonstrate any prognostic or even any other relevant benefit compared to PPCI in any subgroup of patients, even with time delays for PPCI of up to several hours. On average, a median PRD of at least 90-120 min can be considered a time corridor of prognostic superiority of PPCI over TL. This is already achieved in contemporary registries and myocardial infarction networks.Therefore, the efforts should not focus on the implementation of a dual reperfusion strategy (PPCI, and prehospital TL in selected cases) in established or upcoming myocardial infarction networks, but concentrate on the availability of PPCI in less than 2 h. TL, as rapid as possible, i.e. prehospital, is a vital treatment option in case of non-existing PPCI facilities within a median time limit of 2 h or even more, a scenario not existing or easily to eliminate in European countries by implementing well organized myocardial infarction networks. This is the mission to be accomplished.

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Percutaneous Coronary Intervention After Successful Fibrinolytic Therapy for ST-Segment Elevation Myocardial Infarction

Cited by 4 publications

References 16 publications

Reperfusión fármaco-invasiva en el manejo del infarto agudo de miocardio en Chile: Un llamado a la acción

Reperfusión fármaco-invasiva en el manejo del infarto agudo de miocardio en Chile: Un llamado a la acción

Prehospital thrombolysis followed by early angiography and percutaneous coronary intervention where appropriate — an underused strategy for the management of STEMI

As time goes by? The fallacy of thrombolysis in STEMI networks

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