Mortality Benefit of Immediate Revascularization of Acute ST-Segment Elevation Myocardial Infarction in Patients With Contraindications to Thrombolytic Therapy

Authors:
  • ECElizabeth A. Clements
    Elizabeth A. Clements
  • LPLori Parsons
    Lori Parsons
  • RWRobert Welch
    Robert Welch
  • ATAnne T. Tintinalli
    Anne T. Tintinalli
  • MRMichael A. Ross
    Michael A. Ross
  • RZRobert J. Zalenski
    Robert J. Zalenski
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Abstract
Thrombolytic therapy is the most widely used method of achieving coronary artery reperfusion in patients with acute ST-segment elevation myocardial infarction (STEMI).1,2 Evidence shows that percutaneous coronary intervention may be more effective than thrombolytic therapy, but this treatment is limited to institutions capable of 24-hour cardiac catheterization, percutaneous coronary intervention, and coronary artery bypass graft surgery.3-6 The 1999 American College of Cardiology/American Heart Association (ACC/AHA) guidelines classified mechanical reperfusion as a class IIA recommendation (conflicting evidence but weight in favor of efficacy) for managing acute myocardial infarction (AMI) in patients with STEMI who have contraindications to thrombolytic therapy.4