Title: Present status of rescue coronary angioplasty: current polarization of opinion and randomized trials
Authors: Ellis, S G ×
Van de Werf, Frans
Ribeiro-daSilva, E
Topol, E J #
Issue Date: Mar-1992
Series Title: Journal of the American College of Cardiology vol:19 issue:3 pages:681-6
Abstract: Whereas coronary angioplasty has been demonstrated to be unnecessary and perhaps harmful for most patients after successful thrombolytic treatment of acute myocardial infarction, the clinical benefit of rescue angioplasty after failed thrombolysis remains untested in a randomized clinical trial. However, in the clinical judgment of many physicians it is unethical to withhold such treatment, whereas a nearly equal number of physicians believe that such treatment cannot be justified. A review of reported nonrandomized data from a limited number of patients suggests that 1) coronary angioplasty is successful in only 80% of patients after failed thrombolysis, 2) later reocclusion rates may depend on the thrombolytic agent used, 3) left ventricular ejection fraction is seldom improved, and 4) mortality rates after successful angioplasty approximate those after successful thrombolysis alone but mortality rates after failed angioplasty are remarkably high. The arguments for and against rescue angioplasty are reviewed, and it is concluded that results of randomized trials are needed to replace disparate clinical opinion on whether this potentially costly form of therapy should be widely implemented.
ISSN: 0735-1097
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Cardiology
× corresponding author
# (joint) last author

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