The role of angioplasty in acute myocardial infarction.
The role of primary angioplasty versus thrombolytic therapy for the treatment of coronary thrombosis has been the subject of recent randomised trials. They have shown a higher early patency rate after angioplasty with no differences in later patency. Recurrent ischaemia was more frequent after thrombolysis, but the one study that examined myocardial salvage showed no difference. There were fewer intracerebral bleeds in the angioplasty group, but owing mostly to much higher than usual stroke occurrence in the thrombolysis group. With less than 800 patients in all the studies, no final conclusions can yet be drawn about effects on mortality and larger studies are needed. Primary angioplasty is an option when operators are skilled and the procedure can be done quickly.
Ross
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Division of Cardiology, George Washington University, Washington, DC.
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D002561:Cerebrovascular Disorders / Q000209:etiology; D006801:Humans; D009203:Myocardial Infarction / Q000188:drug therapy / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D015912:Thrombolytic Therapy / Q000009:adverse effects