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Recent findings indicate that rescue and systematic early percutaneous coronary intervention (PCI) strategies are the most effective of PCI treatments for patients following treatment of ST-segment elevation myocardial infarction with fibrinolysis. A series of 15 randomized trials studied the effects of various PCI treatments on 5,253 patients. Rescue PCI for failed fibrinolysis had the most significant impact on patient mortality, resulting in a mortality rate of 6.9% (compared with 10.7% of non-PCI patients). The treatment also lowered the rate of death or reinfarction to 10.8% (compared with 16.8% in non-PCI patients). Systematic and early PCI patients also experienced a slight reduction in mortality rates, compared with ischemia-directed PCI. However, fibrinolysis-facilitated PCI didn't significantly affect patient mortality, and appeared to increase the risk of reinfarction (5.0% of patients compared with 3.0% of those receiving primary PCI alone).

 

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Douglas D. Rescue or systematic early PCI seen advantageous after MI treated with fibrinolysis. Reuters Health. Available at: http://www.reutershealth.com/archive/2006/10/19/professional/links/20061019clin0. Accessed December 13, 2006.