Related Experiment Video

Updated: Mar 30, 2026

Catheter-based Endovascular Angioplasty for Fibrosing Mediastinitis-associated Pulmonary Vein Stenosis
06:59

Catheter-based Endovascular Angioplasty for Fibrosing Mediastinitis-associated Pulmonary Vein Stenosis

Published on: August 26, 2025

724

Percutaneous Coronary Intervention after Fibrinolysis for ST-Segment Elevation Myocardial Infarction Patients: An

Feng Liu1, Qinglong Guo2, Guoqiang Xie2

  • 1Department of Postgraduate, Third Military Medical University, Chongqing; 2, Department of Cardiology, Kunming General Hospital of Chengdu Military Area, Yunnan, China.

Plos One
|November 3, 2015
PubMed

Insights

Early percutaneous coronary intervention (PCI) after fibrinolysis is beneficial for ST-segment elevation myocardial infarction (STEMI) patients unable to receive timely PCI. However, immediate PCI following fibrinolysis increases mortality and re-infarction risks.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Acute Coronary Syndromes

Background:

  • ST-segment elevation myocardial infarction (STEMI) management involves percutaneous coronary intervention (PCI), fibrinolysis, or combination therapy.
  • Evaluating the optimal timing of PCI after fibrinolysis is crucial for patient outcomes.

Purpose of the Study:

  • To compare the efficacy and safety of PCI after fibrinolysis within 24 hours versus primary PCI alone and ischemia-guided or delayed PCI.
  • To determine the optimal therapeutic strategy for STEMI patients.

Main Methods:

  • A systematic literature search was conducted across PubMed, EMBASE, Google Scholar, and Cochrane Controlled Trials Register.
  • Randomized controlled trials (RCTs) evaluating PCI after fibrinolysis were meta-analyzed using Review Manager 5.30.

Main Results:

  • Immediate PCI (≤2 hours post-fibrinolysis) showed higher short-term mortality and re-infarction rates compared to primary PCI alone.
  • Early PCI (2-24 hours post-fibrinolysis) demonstrated no significant difference in short-term mortality or re-infarction versus primary PCI alone.
  • Both immediate and early PCI increased major bleeding events compared to primary PCI alone.
  • Early PCI significantly reduced re-infarction and recurrent ischemia compared to ischemia-guided or delayed PCI, both short-term and long-term.

Conclusions:

  • Early PCI after fibrinolysis is a viable option for STEMI patients unable to receive timely primary PCI, offering similar effects to primary PCI alone.
  • Immediate PCI after fibrinolysis is associated with detrimental outcomes.
  • Early PCI is superior to ischemia-guided or delayed PCI in reducing re-infarction and recurrent ischemia.
Abstract

More Related Videos

Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction05:26

Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction

Published on: May 28, 2019

9.8K
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

12.8K

Related Concept Videos

Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
1.7K
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
450
Clot Retraction and Fibrinolysis01:16

Clot Retraction and Fibrinolysis

After a fibrin clot is formed, the next step is clot retraction, a vital process facilitated by platelet contractile proteins, such as actin and myosin. These proteins pull the fibrin strands closer together and condense the clot. This action reduces the size of the clot, creating a smaller, denser structure that effectively seals off the damaged vessel. Clot retraction consolidates the clot and helps with wound healing by bringing the edges of the damaged blood vessel closer together.
10.2K
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
657
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
426
Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
465