Abstract
In this present series of “Mini-Review: Expert Opinions,” leading clinical investigators present their cases for treatment of acute ST-segment elevation myocardial infarction with thrombolytic therapy or percutaneous coronary intervention (PCI). The investigators review relevant studies and their own experience that support their positions. A review of information provided by Drs Armstrong, Collen, and Antman1 and Grines, Serruys, and O’Neill,2 as well as other relevant literature related to the treatment of acute ST-elevation myocardial infarcts, would lead the unbiased reviewer to conclude that the optimal therapy presently available is an acute intervention, ie, PCI (or surgical revascularization), if that procedure can be done by experts within at least 90 minutes of the event. One obtains the most rapid opening of the infarct-related artery and the best perfusion of the infarct-injured zone associated with no or little risk of intracerebral hemorrhage with PCI. However, this is not always possible to do. Many infarcts occur in the early morning hours in patients at considerable distances from a hospital where such therapy is available. In other cases, the necessary facility may not be available in a timely …
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