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• W64691818 abstract "Rescue or salvage percutaneous coronary intervention (PCI) is defined as PCI of the infarct-related artery (IRA) within 12 hours from the onset of ischemic symptoms, after failed fibrinolytic therapy, in patients with continuing myocardial ischemia [1]. Early restoration of patency of the infarct-related artery is a universally accepted goal in the treatment of acute ST-segment elevation myocardial infarction. In the Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries (GUSTO) angiographic sub-study, the 30-daymortality rate was 4.4% for patients with normal coronary artery flow at 90minutes, whereas it was 8.9% for those with occluded arteries at 90 minutes, regardless of the subsequent therapeutic strategy (P = 0.009) [2]. Furthermore, the clinical benefit to restoring not only patency but also normalizing flow (Thrombolysis in Myocardial Infarction [TIMI] grade 3) was clearly demonstrated in that trial. In all patients, left ventricular ejection fraction and wall motion was significantly better both acutely and at 5–7 days in patients in whom TIMI grade 3 reperfusion was achieved after thrombolysis, compared to those with TIMI-2 flow. A beneficial trend in the 30-daymortality rate was noted as well with the achievement of TIMI-3 flow when compared to TIMI-2 flow (4.4% vs. 7.4%, P = 0.08) [2]. These data are consistent with those reported in earlier multicenter studies and meta-analyses, including a series of trials from Germany documenting a 2.7% in-hospitalmortality among patients with TIMI 3 reperfusion, 6.6%with TIMI 2, and 7.1% for persistent occlusion of the IRA [3]. Either thrombolysis or PCI can be used to restore patency of the IRA, but at present and in the foreseeable future, thrombolysis is more globally available and will continute to be more widely used as the first-line approach. However, the patency rate (defined as TIMI grade 2 or 3 flow) at 90 minutes of even the" @default.
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• W64691818 date "2008-10-20" @default.
• W64691818 modified "2023-09-26" @default.
• W64691818 title "Rescue Coronary Intervention for Failed Thrombolysis" @default.
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• W64691818 doi "https://doi.org/10.1007/978-1-60327-497-5_7" @default.
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