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Primary PICA superior to thrombolysis in inferior acute MI
THERAPY
Primary percutaneous transluminal coronary angioplasty (PTCA) with the unrestricted use of coronary stents is superior to thrombolysis with accelerated alteplase in patients with high-risk inferior acute myocardial infarction (MI), report researchers from Italy.
In this study, patients with inferior acute MI who had ST-segment depression in ;:: 3 precordial leads (Le. high-risk inferior acute MI) and who presented
within 6 hours of symptom onset were randomised to either receive thrombolysis with accelerated alteplase [rt-PA] (n = 55) or primary PTCA with the unrestricted use of coronary stents (55).
The between-treatment differences in the in-hospital death and reinfarction rates were not statistically significant [see table].
However, significantly fewer PTCA, compared with thrombolysis, recipients experienced recurrent angina pectoris at rest or required target vessel revascularisation. Similar results were obtained at I-year follow-up. Ribichini F, Steffenino G, Dellavalle A, Ferrero V, Vado A, ct aI. Comparison of thrombolytic therapy and primal)' coronary angioplasty with liberal stenting for inferior myocardial infarction with precordial ST-segment depression: immediate and long-term results of a randomized study. Journal of the American College of Cardiology 32: 1687-1694, IS Nov 1998 Il0072>7.,,
1173-832419911169-0001111$01.O<f Adlelntematlonal Limited 11199. All rlghte reeervecl
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Inphanna- II Jan 1l1li11 No. 1169