Abstract
This multicenter trial from the United Kingdom identified 427 patients with ST-segment elevation myocardial infarction who failed to achieve reperfusion (defined as 50% ST segment resolution) within 90 min after thrombolytic therapy. The patients were randomized to receive rescue percutaneous coronary intervention (PCI), repeat thrombolysis or conservative medical treatment, and the primary composite endpoint of death, reinfarction, stroke or severe heart failure within 6 months was measured. Although there was no statistically significant difference in all-cause mortality, PCI was associated with the highest event-free survival, at 85% (95% confidence interval [CI] 79%–91%), compared to 70% (95% CI 63%–78%) for conservative therapy and 69% (95% CI 61%–76%) for repeat thrombolysis.
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