BACKGROUND Early restoration of epicardial flow before primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) has been associated with improved clinical outcomes. METHODS We hypothesized that early administration of the glycoprotein IIb/IIIa inhibitor eptifibatide in the emergency department (ED) would yield superior epicardial flow and myocard...

Primary percutaneous coronary intervention (PCI) has emerged as the preferred therapy for acute ST-segment elevation myocardial infarction (STEMI), as multiple randomized clinical trials and pooled analyses have shown improved clinical outcomes compared with medical reperfusion. Unfortunately, medical centers with 24-hour PCI capability are concentrated in urban areas, relegating many patients ...

BACKGROUND Thrombolysis remains the treatment of choice in ST-segment elevation myocardial infarction (STEMI) when primary percutaneous coronary intervention (PCI) cannot be done within 90 min. However, the best subsequent management of patients after thrombolytic therapy remains unclear. To assess the best management, we randomised patients with STEMI treated by thrombolysis and abciximab at a...

T he use of percutaneous coronary intervention (PCI) has grown dramatically during the past 30 years. Several developments have led to the growth of PCI, including improved equipment, new anticoagulant and antiplatelet drugs, and the evolution of coronary artery stents. Simultaneous with these improvements, the indications for PCI have expanded, and the safety and outcomes of the procedure have...

OBJECTIVES This study sought to assess outcomes in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention (PCI) for unprotected left main (LM) disease. BACKGROUND Limited data are available on outcomes in patients with ST-segment elevation myocardial infarction undergoing LM PCI. METHODS Of 9,075 patients with ST-segment elevation myoc...

BACKGROUND Despite routine use of coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI), no conclusive evidence exists that either modality is superior to medical therapy (MT) alone for treating multivessel coronary artery disease with stable angina and preserved ventricular function. METHODS AND RESULTS The primary end points were total mortality, Q-wave myocardial...

To the Editor We read with interest the results of the PRAGUE-2 trial 1 and its editorial. 2 Widimsky et al. compared the effects of transport for primary percutaneous coronary angioplasty (PCI) and immediate thrombolysis (TL) for patients with acute myocardial infarction (AMI), in the ran-domized trial PRAGUE-2. 1 The authors concluded that long distance transport from a community hospital to ...

AIMS The majority of patients with ST-elevation myocardial infarction (STEMI) are admitted to local hospitals without primary percutaneous coronary intervention (primary PCI) facilities. Acute transferral to an interventional centre is necessary to treat these patients with primary PCI. The present study assessed the reduction in treatment delay achieved by pre-hospital diagnosis and referral d...

OBJECTIVES We evaluated whether patients' clinical status, angioplasty success, or both, should guide discharge after primary angioplasty (i.e., percutaneous coronary intervention [PCI]) for acute myocardial infarction (AMI). BACKGROUND Current guidelines do not address a discharge strategy for AMI patients undergoing successful PCI. METHODS Patients who underwent PCI in Primary Angioplasty...