title: Comparative effectiveness of primary PCI versus fibrinolytic therapy for ST elevation myocardial infarction: a review of the literature.
abstract: OBJECTIVE
  To compare the effectiveness of primary percutaneous coronary intervention (pPCI) and fibrinolytic therapy (FL) for the acute management of ST elevation myocardial infarction (STEMI).
  
  
  METHODS
  A review of guidelines and PubMed literature comparing clinical outcomes of patients with STEMI treated with pPCI or FL.
  
  
  RESULTS
  Earlier trials reported reduced mortality and reinfarction with pPCI. Recent randomized data suggest similar outcomes for delayed pPCI compared with FL, especially in geographically remote areas. Guidelines recommend pPCI as the preferred reperfusion strategy for STEMI, if available within 120 mins of first medical contact.
  
  
  CONCLUSIONS
  pPCI is the preferred treatment strategy for STEMI. However, FL with subsequent percutaneous coronary intervention remains a viable option for those in rural areas.
authors.affiliation: York Teaching Hospital, NHS Foundation Trust, York, UK.
authors.forename: Eleanor R
authors.initials: ER
authors.lastname: Joy
authors.affiliation: Bradford Royal Infirmary, Bradford Teaching Hospital Trust, Bradford, UK.
authors.forename: John
authors.initials: J
authors.lastname: Kurian
authors.affiliation: York Teaching Hospital, NHS Foundation Trust, York, UK.
authors.forename: Chris P
authors.initials: CP
authors.lastname: Gale
mesh_terms: D057186:Comparative Effectiveness Research / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D062645:Percutaneous Coronary Intervention / Q000379:methods* / Q000706:statistics & numerical data; D000072657:ST Elevation Myocardial Infarction / Q000628:therapy*; D015912:Thrombolytic Therapy / Q000379:methods*; D016896:Treatment Outcome
keywords: ST-elevation myocardial infarction; fibrinolytic therapy; primary percutaneous coronary intervention; thrombolysis