title: [Combined reperfusion in patients with acute myocardial infarction].
abstract: Three schemes of treatment were used in the management of 230 patients with acute myocardial infarction: immediate thrombolysis (group 1, n=71), immediate thrombolysis followed by angioplasty in 12 hours-7 days depending of the clinical picture of the disease (group 2, n=65), primary angioplasty not later than 12 hours after onset of pain (group 3, n=94). Clopidogrel was given to all patients at least in 2 hours before primary angioplasty and no less than in 6 hours in combined reperfusion. Composite end point (total number of lethal outcomes and nonfatal reinfarctions) was significantly higher in group 1 (14.1%) compared with groups 2 (3.0%) and 3 (3.2%). Invasive intervention improved results of treatment after both effective and ineffective preceding thrombolytic therapy. Thus efficacy of combined reperfusion therapy is not inferior to primary angioplasty if interval between thrombolysis and invasive intervention varies between 12 hours and 7 days and angioplasty is carried out at the background of antiaggregant therapy with clopidogrel and aspirin.
authors.forename: A V
authors.initials: AV
authors.lastname: Shpektor
authors.forename: E Iu
authors.initials: EIu
authors.lastname: Vasil'eva
authors.forename: V G
authors.initials: VG
authors.lastname: Artamonov
authors.forename: A G
authors.initials: AG
authors.lastname: Bilich
authors.forename: R Iu
authors.initials: RIu
authors.lastname: Reztsov
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D015425:Myocardial Reperfusion / Q000379:methods*; D012189:Retrospective Studies; D012426:Russia / Q000453:epidemiology; D015996:Survival Rate; D015912:Thrombolytic Therapy / Q000379:methods; D016896:Treatment Outcome