The role of angioplasty in acute myocardial infarction.
The role of percutaneous transluminal coronary angioplasty (PTCA) in the management of acute myocardial infarction (AMI) has not yet been precisely defined. The longest experience with PTCA in this setting has been in patients who are not candidates for thrombolytic therapy and in patients in whom thrombolysis has failed. Clinical interest has recently focused on direct use of PTCA (instead of thrombolysis) as the initial approach to reperfusion in AMI. We review the conceptual bases for both thrombolytic therapy and PTCA in AMI, and we then detail the clinical experience with PTCA in a variety of patient populations with AMI to guide use of both therapies in this setting.
Rose
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Cardiac Unit, Massachusetts General Hospital, Boston, USA.
O'Gara
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PT
D000208:Acute Disease; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D000075202:Contraindications; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D006801:Humans; D009203:Myocardial Infarction / Q000188:drug therapy / Q000628:therapy*; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D012307:Risk Factors; D015912:Thrombolytic Therapy