[Role of angioplasty in acute myocardial infarction].
Angioplasty as the treatment of acute myocardial infarction has proven to be effective in restoring arterial patency and in reducing residual stenosis, although reocclusion and restenosis may be high. Despite the good results reported by several investigators none of the prospective randomized trials comparing thrombolytic therapy with angioplasty (either alone or associated to thrombolysis) has shown any improvement in survival, the latter strategy being associated with an excess of acute complications. However, primary angioplasty may be useful in selected subgroups such as those with cardiogenic shock or with absolute contraindications for thrombolysis. The role of rescue angioplasty still needs to be defined in properly designed studies. In conclusion, primary angioplasty in acute myocardial infarction should be restricted to patients in whom thrombolytic therapy has been shown to be harmful or ineffective.
Betriu
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A
Servicio de Cardiología, Hospital Clínic i Provincial de Barcelona, Universidad de Barcelona.
Heras
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M
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D006801:Humans; D015337:Multicenter Studies as Topic; D009203:Myocardial Infarction / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D015912:Thrombolytic Therapy
Papel de la angioplastia en el infarto agudo de miocardio.