Routine Early Angioplasty after Fibrinolysis for Acute Myocardial Infarction
Transferring heart attack patients to specialized hospitals to undergo angioplasty within six hours after receiving clot-busting drugs reduces the risk of life-threatening complications including repeat heart attacks, according to a new study from St. Michael's Hospital and Southlake Regional Hospital.
The findings, published recently in the New England Journal of Medicine
Results Cardiac catheterization was performed in 88.7% of the patients assigned to standard treatment a median of 32.5 hours after randomization and in 98.5% of the patients assigned to routine early PCI a median of 2.8 hours after randomization. At 30 days, the primary end point occurred in 11.0% of the patients who were assigned to routine early PCI and in 17.2% of the patients assigned to standard treatment (relative risk with early PCI, 0.64; 95% confidence interval, 0.47 to 0.87; P=0.004). There were no significant differences between the groups in the incidence of major bleeding.
* Patients who received the earlier angioplasty had lower rates of experiening chest pain (0.2 per cent as compared to 2.1 percent)
* These same patients had fewer episodes of second heart attacks (3.4 per cent v 5.7 per cent)