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INTERVENTIONAL CARDIOLOGY
Year : 2000  |  Volume : 1  |  Issue : 7  |  Page : 264-271

Primary angioplasty for acute myocardial infarction


Director, Cardiac Catheterization Laboratory, Cardiology and Cardiovascular Surgery, Hamad Medical Corporation, P. O. Box 3050, Doha, Qatar

Correspondence Address:
Jan Horak
Director, Cardiac Catheterization Laboratory, Cardiology and Cardiovascular Surgery, Hamad Medical Corporation, P. O. Box 3050, Doha
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Source of Support: None, Conflict of Interest: None


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Early rapid and long-lasting reperfusion is the most important factor in reducing mortality and morbidity in AMI. Both intravenous thrombolytic therapy and primary PTCA are effective treatment modalities in this respect. Although the debate over relative merits of each of these treatment possibilities is likely to continue, existing evidence shows that primary PTCA with stenting is currently the most effective method of acute reperfusion therapy for patients who present to institutions and operators with the requisite expertise. If mechanical reperfusion can be offered to a patient with AMI within 60 to 90 minutes by a team with a 90% success rate, it should be the treatment of choice. The decision should be based on a rigorous scrutiny of local experience and results and if these targets cannot be met, thrombolysis is probably the better option. For the majority of patients, however, the logistics of providing primary angioplasty is, at the present time, prohibitive and they will have to rely on improvements in thrombolytic therapy as well as on strategies to deliver it as quickly as possible to all eligible patients. The future of reperfusion therapy may be a combination of both approaches, which would eliminate the inherent disadvantages of each modality. Progress in this fast developing field will bring further improvement in the prognosis and outcomes of acute myocardial infarction patients.


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