When should patients with acute myocardial infarction be transferred for primary angioplasty?

摘要

The results of several randomised trials have shown supe- rior outcomes with primary angioplasty for acute myocar- dial infarction compared to thrombolytic treatment. Pri- mary angioplasty establishes TIMI-3 flow in the infarct artery in 93-97/100 of patients compared with 54/100 with accelerated t-PA. Pooled data from three randomised trials have shown lower hospital mortality (2.2/100 v 5.9/100, p = 0.02) and less non-fatal re-infarction (1.9/100 v 8.1/100, p = 0.001) in patients treated with primary angioplasty versus thrombolytic treatment.