Routine Angioplasty after Fibrinolysis — How Early Should "Early" Be?  

Oleh:

Verheugt, Freek W.A.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The New England Journal of Medicine (keterangan: ada di Proquest) vol. 360 no. 26 (Jun. 2009), page 2779-2781.
Topik: Angioplasty; Fibrinolysis

Ketersediaan

Perpustakaan FK Nomor Panggil: N08.K.2009.03 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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PDF PDA Full Text Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear Related Article by Cantor, W. J. PubMed Citation Reperfusion therapy has represented a great leap forward in the management of myocardial infarction with ST-segment elevation. Its goal is early and complete recanalization of the infarct-related artery to salvage myocardium and improve both early and late clinical outcomes. Complete reperfusion can be achieved with either fibrinolysis or primary percutaneous coronary intervention (PCI), but with primary PCI the success rate is higher than 90%, whereas current fibrinolytic therapy leads to full reperfusion in only 50 to 55% of recipients. Primary PCI, therefore, looks like the most appropriate reperfusion tool, but there are substantial logistic restrictions associated with it. The door-to-balloon time with primary PCI is typically longer than the time within which in-hospital fibrinolytic therapy can be initiated, and primary PCI requires a network of dedicated ambulances and emergency departments to shorten the door-to-balloon time as much as possible. Primary PCI is an especially attractive strategy in the United States, where nearly 80% of the adult population lives within 1 hour's drive of a PCI center.

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