PMID: 2122855Aug 1, 1990Paper

Immediate delayed coronary angioplasty after intravenous thrombolysis in myocardial infarction. Prospective study

Archives des maladies du coeur et des vaisseaux
J L BonnetG Habib

Abstract

A prospective randomized study was undertaken in 50 patients treated with intravenous thrombolysis (streptokinase, tissue plasminogen activator, association of the two thrombolytics) for acute myocardial infarction to determine the best time to perform percutaneous transluminal coronary angioplasty (PTCA). Coronary angiography was carried out 24 to 72 hours after thrombolysis. This investigation allowed identification of the patients in whom PTCA was technically feasible. These patients were then divided into two groups: Group A: early PTCA (24-72 hours) and Group B: delayed PTCA (8-10 days). During the hospital period, the patients were prescribed heparin therapy and aspirin. Recurrent ischemia (RI) was investigated and treated by PTCA. The criteria of success of strategies A and B were a primary success of PTCA and no RI during the hospital period. Coronary angiography was performed in 108 successive patients of whom 50 were included for the comparative trial, 25 in Group A and 25 in Group B. In group A, PTCA was successful in 24 cases and there were 2 incidents of RI (6 hours and 12 days). In Group B, 4 episodes of RI were observed in the 24 hours following coronary angiography: after 10 days, 15 of the 20 patients with unco...Continue Reading

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