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Fibrinolytic treatment of ST-elevation myocardial infarction. Update 2014.
MedLine Citation:
PMID:  24085113     Owner:  NLM     Status:  Publisher    
Primary percutaneous coronary intervention (PPCI) is the preferred reperfusion therapy in ST-elevation myocardial infarction (STEMI), as long as it can be delivered within 90-120 minutes from patient's first medical contact, and is the leading reperfusion strategy in most European countries. However, as PPCI cannot be offered in a timely manner to all patients, fibrinolytic therapy (FT) is the recommended choice in patients with an anticipated delay to PPCI of >90-120 minutes, presenting early after symptom onset and without contra-indications. FT should preferably be started in the pre-hospital setting. Following FT, all patients should be transferred to a PCI-center for rescue PCI or routine coronary angiography with PCI as indicated. Such a pharmaco-invasive strategy, combining FT with invasive treatment, has recently been shown to be non-inferior to PPCI in patients living in areas with long transfer delays to PCI (>60 minutes). In this overview, we will briefly present the evidence for the benefit of FT in STEMI, and discuss the role of FT in the current era of PPCI as well as the optimal treatment following pharmacologic reperfusion.
S Halvorsen; K Huber
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-10-02
Journal Detail:
Title:  Hamostaseologie     Volume:  34     ISSN:  0720-9355     ISO Abbreviation:  Hamostaseologie     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-10-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8204531     Medline TA:  Hamostaseologie     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Dr. Sigrun Halvorsen, Department of Cardiology, Oslo University Hospital Ullevål, 0407 Oslo, Norway, Tel. +47/22 11 91 01; Fax +47/22 11 91 81, E-mail:;
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