| Facilitated percutaneous coronary intervention. | |
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MedLine Citation:
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PMID: 16978993 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The goal of the initial treatment for ST-segment elevation myocardial infarction is rapid and effective reperfusion. Randomized trials have demonstrated that primary angioplasty is preferred over thrombolysis if done in a timely manner and by an experienced team. However, due to many factors, performance of primary angioplasty within the goal of 90 min is often not possible. A combined strategy of immediate thrombolysis in the emergency room or in the ambulance followed by angioplasty theoretically could provide early reperfusion with subsequent angioplasty to insure complete reperfusion. Over 17 clinical trials have been reported. Compared with thrombolysis, facilitated angioplasty in the most recent trials has been shown to have a more favorable long-term outcome. Trials comparing facilitated angioplasty with full- or half-dose thrombolysis versus primary angioplasty have been far less favorable with the largest trial to date, the ASSENT (Assessment of the Safety and Efficacy of a New Treatment Strategy with Percutaneous Coronary Intervention)-4 trial, demonstrating a worse outcome in the primary end point of death, congestive heart failure, or shock at 90 days. Pending the results of the FINESSE (Facilitated Intervention with Enhanced Reperfusion Speed to Stop Events) trial, current data suggest that facilitated angioplasty does not offer any advantage over primary angioplasty and may be harmful. |
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Authors:
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William B Borden; David P Faxon |
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Publication Detail:
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Type: Journal Article; Review Date: 2006-08-28 |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 48 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2006 Sep |
Date Detail:
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Created Date: 2006-09-18 Completed Date: 2006-10-17 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1120-8 Citation Subset: AIM; IM |
Affiliation:
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Section of Cardiology, Department of Medicine, University of Chicago, Chicago, Illinois, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Angioplasty, Transluminal, Percutaneous Coronary* Humans Meta-Analysis as Topic Randomized Controlled Trials as Topic Thrombolytic Therapy / methods Treatment Failure |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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