2005Chinese Journal of Interventional CardiologyRequires access

Evaluation of combined thrombolysis and precutaneous coronary intervention in acute myocardial infarction

Bing Xie

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Abstract

Objective Evaluation of the benefit and safety of combined thrombolysis and precutaneous coronary intervention in acute myocardial infarction by retrospective analysis. Methods Precutaneous coronary intervention were performed in 45 patients with acute myocardial infarction immediately after thrombolysis. The clinical and angiographic data were compared with that of 31 patients with thrombolysis alone and 74 patients with primary precutaneous coronary intervention in the same period. Results Angiographic data showed that patients with PCI plus thrombolysis had more frequency of TIMI 3 flow than patients with thrombolysis alone (88.9% vs. 74.2%, P=0.087). Patients with PCI plus thrombolysis and with primary PCI had similar frequency of TIMI 3 flow (88.9% vs. 91.9% P=0.404). Clinical data showed that patients with PCI plus thrombolysis had less major adverse cardiovascular events in hospital than patients with thrombolysis alone (4.4% vs. 12.9%, P=0.181). Patients with PCI plus thrombolysis and with primary PCI had similar major adverse cardiovascular events (4.4% vs. 1.4%, P=0.319). Patients with three strategies of treatment had similar mortality (4.4% vs. 6.5% vs. 4.1%). Patients with three strategies of treatment had similar major bleeding events (4.4% vs. 3.2% vs. 1.4%) in hospital. Conclusion Combined thrombolysis and precutaneous coronary intervention maybe surpass thrombolysis alone, at least similar to primary PCI. This strategy of treatment is safe.

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Objective Evaluation of the benefit and safety of combined thrombolysis and precutaneous coronary intervention in acute myocardial infarction by retrospective analysis. Methods Precutaneous coronary intervention were performed in 45 patients with acute myocardial infarction immediately after thrombolysis. The clinical and angiographic data were compared with that of 31 patients with thrombolysis alone and 74 patients with primary precutaneous coronary intervention in the same period. Results Angiographic data showed that patients with PCI plus thrombolysis had more frequency of TIMI 3 flow than patients with thrombolysis alone (88.9% vs. 74.2%, P=0.087). Patients with PCI plus thrombolysis and with primary PCI had similar frequency of TIMI 3 flow (88.9% vs. 91.9% P=0.404). Clinical data showed that patients with PCI plus thrombolysis had less major adverse cardiovascular events in hospital than patients with thrombolysis alone (4.4% vs. 12.9%, P=0.181). Patients with PCI plus thrombolysis and with primary PCI had similar major adverse cardiovascular events (4.4% vs. 1.4%, P=0.319). Patients with three strategies of treatment had similar mortality (4.4% vs. 6.5% vs. 4.1%). Patients with three strategies of treatment had similar major bleeding events (4.4% vs. 3.2% vs. 1.4%) in hospital. Conclusion Combined thrombolysis and precutaneous coronary intervention maybe surpass thrombolysis alone, at least similar to primary PCI. This strategy of treatment is safe.

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Available abstract

Objective Evaluation of the benefit and safety of combined thrombolysis and precutaneous coronary intervention in acute myocardial infarction by retrospective analysis. Methods Precutaneous coronary intervention were performed in 45 patients with acute myocardial infarction immediately after thrombolysis. The clinical and angiographic data were compared with that of 31 patients with thrombolysis alone and 74 patients with primary precutaneous coronary intervention in the same period. Results Angiographic data showed that patients with PCI plus thrombolysis had more frequency of TIMI 3 flow than patients with thrombolysis alone (88.9% vs. 74.2%, P=0.087). Patients with PCI plus thrombolysis and with primary PCI had similar frequency of TIMI 3 flow (88.9% vs. 91.9% P=0.404). Clinical data showed that patients with PCI plus thrombolysis had less major adverse cardiovascular events in hospital than patients with thrombolysis alone (4.4% vs. 12.9%, P=0.181). Patients with PCI plus thrombolysis and with primary PCI had similar major adverse cardiovascular events (4.4% vs. 1.4%, P=0.319). Patients with three strategies of treatment had similar mortality (4.4% vs. 6.5% vs. 4.1%). Patients with three strategies of treatment had similar major bleeding events (4.4% vs. 3.2% vs. 1.4%) in hospital. Conclusion Combined thrombolysis and precutaneous coronary intervention maybe surpass thrombolysis alone, at least similar to primary PCI. This strategy of treatment is safe.

Key concepts: Thrombolysis, TIMI, Medicine, Conventional PCI, Myocardial infarction, Cardiology, Percutaneous coronary intervention, Internal medicine

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