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- Title
Pharmaco-invasive versus Invasive-only Strategies in Therapy of ST-Elevation Myocardial Infarction: Comparative Study.
- Authors
Elrayes, Mahmoud M.; Kandil, Abdelhakim M.; Refaie, Wael M.; Gomaa, Gamal F.
- Abstract
Background: Primary percutaneous coronary intervention (PCI) for ST- elevation myocardial infarction (STEMI) remains the default strategy. However, when primary PCI cannot be performed expeditiously, a pharmaco-invasive strategy of fibrinolysis followed by PCI may be a reasonable alternative. This study is conducted to determine whether pharmaco-invasive strategy using fibrinolysis followed by routine early PCI represents a reasonable alternative to primary PCI when it is not readily available especially in patients with STEMI presenting early after symptom onset. Methods: This is an observational prospective comparative singlecenter study that was conducted on acute STEMI patients who were presented within 12 hours from onset of symptoms at cardiovascular medicine department, Mansoura University Hospital; in the period from 1st February 2017 till 28th February 2019. The study includes two groups of STEMI patients; pharmaco-invasive group: involving 43 patients and primary PCI group: involving 51 patients; with a one month follow up comparing the safety and efficacy. Results: Thrombolysis in Myocardial Infarction (TIMI) grade was better in pharmaco-invasive group (p=0.017), while there was no statistically significant difference in post PCI TIMI grade. Post-PCI myocardial perfusion grade was better in pharmacoinvasive group (P = 0.045). There was no statistically significant difference between the two groups regarding in-hospital complications (p=0.136) or complications at 1 month follow up (P ˃ 0.05). Conclusion: A pharmaco-invasive strategy is non-inferior to primary PCI in terms of reperfusion and complications.
- Subjects
MYOCARDIAL infarction; PERCUTANEOUS coronary intervention; FIBRINOLYSIS; THROMBOLYTIC therapy; CARDIOVASCULAR diseases
- Publication
Zagazig University Medical Journal, 2023, Vol 29, Issue 2, p638
- ISSN
1110-1431
- Publication type
Article