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Meta-analysis picks angioplasty over thromboIysisinMI

Percutaneous transluminal coronary angioplasty (PTCA) gave MI patients better odds of in-hospital survival than thrombolysis, according to a meta­analysis of 5 randomised. controlled trials involving 960 patients.

This result, together with other benefits of angioplasty 'may justify the adoption of angio­plasty as the primary strategy' for post-MI arterial recanalisation. says study author Dr Paul T Vaitkus of the Vermont ColIege of Medicine. US.

However, Dr Vaitkus cautions that this conclusion applies only where angioplasty is readily available. He Dotes that thrombolysis is still the 'most

appropriate first-line therapy' in the vast majority of cases, due to the limited availability of angioplasty.

A similar trend favouring angiopJasty was also seen when these 5 studies were considered with 2 other trials, one involving only patients with anterior MI, the other utilising an historical control group. The death rate was 3.2% in the 689 patients receiving angioplasty compared with 6.1 % in 609 patients receiving thrombolysis.

Vaitkus PT. Pcn:utaDcoUs cranslwninal <::Or1JIIary mgiopWry V=~$ thtoInbolys.is

ill ""ute myocanI.ial inflIn:tion: a mr:tI·..wy.i •. ClinicII Cardiology 18; 35·38. Jan 19115

,.. Editorial commenJ: A recent report by a group whose earlier results were included in this study {see Inpharma 969: 20, 14 JtJIII995; 800323291 J warned against extrapolating their results to all patients with MI, as their angioplasty success rate may ho.ve been exceptionally high.

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