Primary percutaneous transluminal coronary angioplasty (PTCA) offers a better prognosis for patients with acute ST-segment elevation myocardial infarction (AMI) than thrombolytic therapy, finds a systematic review by American clinicians.
Dr. Ellen Keeley and colleagues of the division of cardiology, University of Texas Southwestern Medical Center, Dallas, Texas, United States, assessed the combined results of 23 trials.
Overall, among 7,739 thrombolytic-eligible patients with AMI, 3,872 were randomly assigned to primary PTCA and 3,867 to thrombolytic therapy. Streptokinase was used in eight trials involving 1,837 patients, and fibrin-specific agents in 15 trials in 5,902 patients. Most patients given thrombolytic therapy (76 percent) received a fibrin-specific agent. Stents were used in 12 trials, and platelet glycoprotein IIb/IIIa inhibitors were used in eight trials.
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