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Rescue thrombolysis may work even though primary thrombolysis has failed

Joost P.H. Drenth, Astrid Uppelschoten, Ton E.H Hooghoudt, E. J. P. Lamfers

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Abstract

EDITOR—Gershlick and More discuss the new therapeutic options for myocardial infarction and suggest that patients in whom thrombolysis fails should receive rescue angioplasty.1 We challenge this view and propose that rescue thrombolysis might be considered in cases in which primary thrombolysis has failed. Two trials have compared rescue angioplasty with conservative management, with equivocal results. 2 3 One trial randomised patients with an occluded artery three hours after the onset of symptoms; it detected a non-significant reduction in mortality in the angioplasty group …

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What this paper is about

EDITOR—Gershlick and More discuss the new therapeutic options for myocardial infarction and suggest that patients in whom thrombolysis fails should receive rescue angioplasty.1 We challenge this view and propose that rescue thrombolysis might be considered in cases in which primary thrombolysis has failed. Two trials have compared rescue angioplasty with conservative management, with equivocal results. 2 3 One trial randomised patients with an occluded artery three hours after the onset of symptoms; it detected a non-significant reduction in mortality in the angioplasty group …

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Available abstract

EDITOR—Gershlick and More discuss the new therapeutic options for myocardial infarction and suggest that patients in whom thrombolysis fails should receive rescue angioplasty.1 We challenge this view and propose that rescue thrombolysis might be considered in cases in which primary thrombolysis has failed. Two trials have compared rescue angioplasty with conservative management, with equivocal results. 2 3 One trial randomised patients with an occluded artery three hours after the onset of symptoms; it detected a non-significant reduction in mortality in the angioplasty group …

Key concepts: Thrombolysis, Primary angioplasty, Medicine, Angioplasty, Myocardial infarction, Cardiology, Internal medicine, Percutaneous coronary intervention

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