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Pharmacoinvasive Management

Balaji Pakshirajan1, Vijayakumar Subban1, Ajit S Mullasari1

  • 1Department of Cardiology, Institute of Cardio Vascular Diseases, Madras Medical Mission, 4A Dr. JJ Nagar, Mogappair, Chennai 600037, India.

Interventional Cardiology Clinics
|June 6, 2017
PubMed

Insights

For ST-elevation myocardial infarction (STEMI) patients treated with fibrinolysis, early routine percutaneous coronary intervention (PCI) is superior to conservative care or rescue PCI. This strategy improves outcomes after initial clot-busting treatment.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Emergency Medicine

Background:

  • ST-segment elevation myocardial infarction (STEMI) requires prompt restoration of blood flow.
  • Primary percutaneous coronary intervention (PCI) is the gold standard for STEMI treatment.
  • Fibrinolysis is often used when primary PCI is logistically challenging.

Purpose of the Study:

  • To evaluate the optimal timing and strategy for subsequent percutaneous coronary intervention (PCI) in ST-elevation myocardial infarction (STEMI) patients initially treated with fibrinolysis.

Main Methods:

  • Review of current clinical data and trials comparing different post-fibrinolysis PCI strategies.
  • Analysis of outcomes associated with early routine PCI versus conservative management or rescue PCI.

Main Results:

  • Current evidence favors an early routine PCI strategy after fibrinolysis.
  • This approach demonstrates better outcomes compared to conservative care or rescue PCI for failed lysis.

Conclusions:

  • Early routine PCI following fibrinolysis is the recommended strategy for STEMI patients.
  • This approach offers advantages over conservative management or rescue PCI in selected patients.

Keywords:
Primary percutaneous coronary interventionST-segment elevation myocardial infarctionThrombolysisTotal ischemic time

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