PCI versus Thrombolytics for Acute MI

Multiple trials have now demonstrated the superiority of primary PCI over t-PA thrombolytics for reperfusion therapy during acute myocardial infarction. Delays to reperfusion only widen the gap between PCI and thrombolytics and most studies have not yet evaluated the impact of newer anti-platelet agents and stents on this difference. The benefit of PCI over thrombolytics is likely under-estimated by all of the current meta-analyses. The current data alone, however, support the statement that PCI ought to be considered the standard of care wherever it can be cost-effectively applied in centers with cardiac catheterization volumes similar to those previously studied (> 200 caths/year).

For Best Results in ACS PCI: Treat Upstream With P2Y12 Inhibitors

Pre-treatment with a P2Y12 inhibitor reduces cardiovascular events in the ACS population.

Percutaneous coronary intervention (PCI or angioplasty with stent)

Percutaneous Coronary Intervention (PCI, formerly known as angioplasty with stent) is a non-surgical procedure that uses a catheter (a thin flexible tube) to place a small structure called a stent to open up blood vessels in the heart that have been narrowed by plaque buildup, a condition known as atherosclerosis.

Percutaneous Coronary Intervention in Acute Coronary Syndrome: Completing the Job Saves Lives

Two decades after the TIMI-18 trial showed that an early invasive approach with revascularization was superior to a conservative approach in ACS, we are finally moving to an era in which we will address the equally important question of the optimal revascularization approach.

STEMI: is it time for COMPLETE revascularisation?

Primary percutaneous coronary intervention (PCI) remains the gold-standard method of reperfusion for patients with ST-segment elevation myocardial infarction (STEMI). Half of patients presenting with STEMI have multi-vessel coronary artery disease (CAD), which are additional angiographically significant lesions in locations separate from that of the culprit lesion that caused the acute event. These non-culprit lesions are often discovered at the time of primary PCI and may be angiographically stable or have complex morphologic features. Whether to routinely revascularise the non-culprit lesions or to manage them conservatively with optimal medical therapy is uncertain.