Interventional CardiologyReview of immediate angioplasty after fibrinolytic therapy for acute myocardial infarction: Insights from the RESCUE I, RESCUE II, and other contemporary clinical experiences☆,☆☆
Section snippets
Methods
In light of these changes and to provide additional new data, this report will attempt to summarize currently available data (through review of Medline and abstracts from Circulation, Journal of the American College of Cardiology, and European Heart Journal) on the clinical utility, or lack thereof, of rescue angioplasty.
Intervention for totally occluded vessels
Patients with occluded vessels visualized 90 minutes after administration of fibrinolytic therapy have a mortality rate that is more than twice that noted for patients with TIMI 3 flow (eg, 9.1% vs 4.3%, 30-day mortality rate in GUSTO I, P =.01).18 Only 4 small randomized controlled trials (RCTs)8, 9, 19, 20 (Table I) have critically analyzed whether or not PTCA, applied in a timely fashion, is beneficial to patients who are at such high risk.
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Guest Editor for this manuscript was Christopher E. Buller, MD, Vancouver Hospital and Health Sciences Center, Vancouver, British Columbia, Canada.
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Reprint requests: Stephen G. Ellis, MD, The Cleveland Clinic Foundation, 9500 Euclid Ave, F-25, Cleveland, OH 44195.E-mail: [email protected]