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Early primary angioplasty is the current standard for patients with ST-segment-elevation myocardial infarction (STEMI). However, logistical hurdles often make the national standard of a 90-minute door-to-balloon time impossible. In an industry-sponsored, multicenter, unblinded, controlled trial, researchers evaluated whether use of full-dose fibrinolytic agents safely and effectively widens the therapeutic window for percutaneous coronary intervention (PCI).
Investigators randomized 212 patients who presented with STEMI to receive either early PCI (within 3 hours) or immediate full-dose tenecteplase followed by PCI within 3 to 12 hours. Complete reperfusion after PCI was significantly more common in the fibrinolysis group than in the early-P…