TY - JOUR
T1 - Facilitated percutaneous coronary intervention
T2 - Current concepts, promises, and pitfalls
AU - Kiernan, Thomas J.
AU - Ting, Henry H.
AU - Gersh, Bernard J.
PY - 2007/8
Y1 - 2007/8
N2 - The reperfusion era has dramatically and irrevocably transformed the management of ST-segment elevation myocardial infarction (STEMI). For the patient treated with fibrinolysis as the initial reperfusion strategy, subsequent options which are the subject of some controversy and the focus of this review are (i) facilitated percutaneous coronary intervention (PCI); (ii) pharmacoinvasive approach; (iii) 'Watchful waiting'. We performed a literature search of all available articles on facilitated PCI published in English language on Medline, including randomized controlled trials, meta-analyses, and review articles. This information provided the core for a critical appraisal of the current literature on this controversial topic. On the basis of current available data, facilitated PCI with a thrombolytic agent has no role in everyday clinical practice and facilitated PCI utilizing a glycoprotein IIbIIIa inhibitor agent has no considerable benefit on mortality in STEMI in contemporary practice. The evidence to date suggests that fibrinolytic- facilitated PCI is associated with higher mortality rates and adverse events compared with primary PCI.
AB - The reperfusion era has dramatically and irrevocably transformed the management of ST-segment elevation myocardial infarction (STEMI). For the patient treated with fibrinolysis as the initial reperfusion strategy, subsequent options which are the subject of some controversy and the focus of this review are (i) facilitated percutaneous coronary intervention (PCI); (ii) pharmacoinvasive approach; (iii) 'Watchful waiting'. We performed a literature search of all available articles on facilitated PCI published in English language on Medline, including randomized controlled trials, meta-analyses, and review articles. This information provided the core for a critical appraisal of the current literature on this controversial topic. On the basis of current available data, facilitated PCI with a thrombolytic agent has no role in everyday clinical practice and facilitated PCI utilizing a glycoprotein IIbIIIa inhibitor agent has no considerable benefit on mortality in STEMI in contemporary practice. The evidence to date suggests that fibrinolytic- facilitated PCI is associated with higher mortality rates and adverse events compared with primary PCI.
KW - Facilitated percutaneous coronary intervention
KW - ST-elevation myocardial infarction
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U2 - 10.1093/eurheartj/ehm222
DO - 10.1093/eurheartj/ehm222
M3 - Review article
C2 - 17573380
AN - SCOPUS:34547780077
SN - 0195-668X
VL - 28
SP - 1545
EP - 1553
JO - European heart journal
JF - European heart journal
IS - 13
ER -