Heart 1997;78:327-328 ( October )
Editorial
When should patients with acute myocardial infarction be transferred for primary angioplasty?
| The first 150 words of the full text of this article appear below. |
The results of several randomised trials have shown superior outcomes with primary angioplasty for acute myocardial infarction compared to thrombolytic treatment.1-4 Primary angioplasty establishes TIMI-3 flow in the infarct artery in 93-97% of patients1,5 compared with 54% with accelerated t-PA.6 Pooled data from three randomised trials have shown lower hospital mortality (2.2% v 5.9%, p = 0.02) and less non-fatal re-infarction (1.9% v 8.1%, p = 0.001) in patients treated with primary angioplasty versus thrombolytic treatment.1-3 Intracranial haemorrhage, the most feared complication of thrombolysis, occurred significantly less often with primary angioplasty versus t-PA in both the PAMI-1 trial (0% v 2.0%, p = 0.05)1 and the GUSTO-IIB trial (0% v 1.4%, p = 0.008).4 In addition, several studies have documented shorter hospital stay and comparable or lower hospital costs with primary angioplasty.7-9 Because of these data, primary angioplasty has emerged as the preferred reperfusion strategy for acute myocardial infarction in institutions with interventional facilities and skilled operators.
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Widimsky, P., Budesinsky, T., Vorac, D., Groch, L., Zelizko, M., Aschermann, M., Branny, M., St'asek, J., Formanek, P., on behalf of the 'PRAGUE' Study Group Investigator,
(2003). Long distance transport for primary angioplasty vs immediate thrombolysis in acute myocardial infarction: Final results of the randomized national multicentre trial--PRAGUE-2. Eur Heart J
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(1998). Importance of time to reperfusion for 30-day and late survival and recovery of left ventricular function after primary angioplasty for acute myocardial infarction. J Am Coll Cardiol
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