Editorial
Infarct angioplasty
| The first 150 words of the full text of this article appear below. |
Although secondary prevention and rehabilitation are essential for optimising care for patients presenting with acute myocardial infarction, the best outcomes are achieved with treatments that rapidly restore normal coronary artery flow and then maintain patency. To minimise time to treatment, patients can either be thrombolysed en route to hospital or be assessed and sometimes treated directly by paramedics in appropriately equipped ambulances (bypassing the family doctor).1-3
Once the patient is in the coronary care unit (CCU), further assessment is required. If no prehospital treatment has been provided, the patient should receive either thrombolytic treatment or primary angioplasty. If thrombolytic therapy has already been given, alternative strategies should be considered if it appears to have failed.
There is still considerable debate about the relative merits of
thrombolytic treatment and angioplasty. The PAMI (primary angioplasty
in myocardial infarction) study group and Zwolle et al have established that primary angioplasty can be highly
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