Abstract
Data from the Strategic Reperfusion Early After Myocardial Infarction (STREAM) trial6 and 5-year results from the French Registry of Acute ST-Elevation and Non-ST-Elevation Myocardial Infarction (FAST-MI)7 are evaluated for further evidence on the effectiveness and safety of a pharmacoinvasive approach for patients presenting with acute ST-segment elevation myocardial infarction (STEMI).
Highlights
Primary percutaneous coronary intervention (PPCI) is currently the preferred reperfusion therapy for patients presenting with acute ST-segment elevation myocardial infarction (STEMI) when it can be performed by an experienced team in a timely fashion.[1]
When this is not feasible, as is the case in many areas around the world, a pharmacoinvasive strategy consisting of early fibrinolysis followed by transfer to a PCI-capable hospital for either immediate PCI for patients with failed thrombolysis, or for non-urgent coronary angiography to determine the need for additional revascularization within 3 – 24 is a reasonable alternative.[2,3]
In agreement with several recent studies[10,11,12,13] as well as the current American and European practice guidelines,[2,3] both Strategic Reperfusion Early After Myocardial Infarction (STREAM) and FAST-MI support the current recommendation of performing a coronary angiogram within 3 –24 hours after successful fibrinolysis when timely PPCI is unavailable
Summary
Primary percutaneous coronary intervention (PPCI) is currently the preferred reperfusion therapy for patients presenting with acute ST-segment elevation myocardial infarction (STEMI) when it can be performed by an experienced team in a timely fashion.[1]. INTRODUCTION Primary percutaneous coronary intervention (PPCI) is currently the preferred reperfusion therapy for patients presenting with acute ST-segment elevation myocardial infarction (STEMI) when it can be performed by an experienced team in a timely fashion.[1] Current practice guidelines recommend the transfer of patients presenting to non-PCI capable hospitals to hospitals offering PPCI services if the first medical contact (FMC)-to-device time is kept to less than 120 minutes.
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