[Thrombolysis or primary PCI: the gold standard in the management of acute myocardial infarction in 2003?].
Several studies published recently show the superiority of a primary percutaneous coronary intervention (I degree PCI) on thrombolysis in the treatment of acute myocardial infarction. This holds true even if PCI is delayed by 2 or 3 hours due to the secondary transfer to a hospital disposing of a cath lab. The advantage consists in a significant decrease in the number of secondary ischemia, recurrent myocardial infarction, hemorrhagic stroke and mortality. We retrospectively analysed the patients admitted in our hospital during 2001 with acute myocardial infarction and criteria for thrombolysis. A third of these patients underwent I degree PCI in a reference center, two thirds underwent thrombolysis in our hospital; 87% of thrombolysed patients underwent secondary PCI during the same hospital stay; in all patients (except one) coronary angiography was completed by a percutaneous (25/30) or surgical (4/30) revascularisation. Given the data in the recent literature and our experience, we consider that I degree PCI has to be favored over thrombolysis for most of the patients presenting to our hospital with acute myocardial infarction.
Laskine
Mikhael
M
Kehtari
Réza
R
Zenklusen
Regula Zürcher
RZ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy*; D015912:Thrombolytic Therapy
D005343:Fibrinolytic Agents