Facilitated percutaneous coronary intervention: Current concepts, promises, and pitfalls

Thomas J. Kiernan, Henry H. Ting, Bernard J. Gersh

Research output: Contribution to journalReview article

23 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1545-1553
Number of pages9
JournalEuropean heart journal
Volume28
Issue number13
DOIs
StatePublished - Aug 1 2007

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Keywords

  • Facilitated percutaneous coronary intervention
  • ST-elevation myocardial infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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