Reperfusion for ST-Segment-Elevation MI: Survival in the Real World

In an observational analysis of contemporary practice in France, survival rates after thrombolysis with subsequent PCI were similar to those after primary PCI.

Using a registry of all patients treated for ST-segment-elevation MI at 223 hospitals in France during a 1-month period in 2005, investigators compared outcomes in 466 who received initial thrombolysis (two thirds before hospital admission) with outcomes in 564 who received primary percutaneous coronary intervention. In contrast to most other comparisons of PCI and thrombolysis, most (96%) of the thrombolysis recipients subsequently underwent coronary angiography, and 84% of them underwent PCI (median time from thrombolytic administration to PCI, 220 minutes). PCI after thrombolysis was part of a planned pharmacoinvasive strategy in 58% of these patients and driven by symptoms (rescue PCI) in the remainder.

In-hospital mortality was 5.0% in …

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI