Immediate Transfer for PCI After Thrombolysis for STEMI

For some high-risk STEMI patients, immediate transfer for PCI improves outcomes, but which patients benefit most from immediate transfer remains unclear.

Primary percutaneous coronary intervention (PCI) is considered the best reperfusion strategy for patients with ST-segment-elevation myocardial infarction (STEMI) when it is available within 90 minutes. If PCI is not rapidly available, thrombolysis is the treatment of choice. Would patients benefit from immediate PCI after thrombolysis?

In a prospective study, 600 patients aged ≤75 years who presented to non-PCI hospitals in France, Italy, and Poland with high-risk STEMI (Killip class >2, left ventricular ejection fraction ≤35%, new left bundle branch block, previous MI, or extensive ST-segment elevation) were treated with half-dose reteplase plus abciximab, heparin, and aspirin. Patients were then randomized to be either immediately transfer…

Reviewing Author

Kristi L. Koenig, MD, FACEP

Disclosures

Editorial boardsKoenig & Schultz's Disaster Medicine: Comprehensive Principles and Practices

Kristi L. Koenig, MD, FACEP

Disclosures

Editorial boardsKoenig & Schultz's Disaster Medicine: Comprehensive Principles and Practices