This Article  • References  • Full text PDF  • Correction  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

A Quantitative Review

W. Douglas Weaver, MD; R. John Simes, MD; Amadeo Betriu, MD; Cindy L. Grines, MD; Felix Zijlstra, MD; Eulogio Garcia, MD; Lilliana Grinfeld, MD; Raymond J. Gibbons, MD; Expedito E. Ribeiro, MD; Marcus A. DeWood, MD; Flavio Ribichini, MD

JAMA. 1997;278(23):2093-2098.

Abstract
Objective.
—To provide a quantitative review of the treatment effects of primary coronary angioplasty vs intravenous thrombolysis for acute myocardial infarction.

Data Sources.
—Ten randomized trials were identified through computerized bibliographic search of MEDLINE from January 1985 through March 1996 and by queries of principal investigators.

Study Selection.
—Single-center and multicenter randomized trials comparing primary angioplasty with intravenous thrombolytic therapy among 2606 patients were included. Four trials compared angioplasty with streptokinase, 3 compared angioplasty with a 3- to 4-hour infusion of tissue-type plasminogen activator, and 3 compared angioplasty with "accelerated" administration of tissue-type plasminogen activator over 90 minutes.

Data Extraction.
—Each investigator provided definitions and exact data for outcome events. Odds ratios (ORs), 95% confidence intervals (CIs), and Pvalues were calculated using exact tests for categorical data.

Data Synthesis.
—Mortality at 30 days or less was 4.4% for the 1290 patients treated with primary angioplasty compared with 6.5% for the 1316 patients treated with thrombolysis (34% reduction; OR, 0.66; 95% CI, 0.46-0.94; P=.02). The effect was similar among thrombolytic regimens, and no subgroup demonstrated a significant reduction in death. The rates of death or nonfatal reinfarction were 7.2% for angioplasty and 11.9% for thrombolytic therapy (OR, 0.58; 95% CI, 0.44-0.76; P<.001). Angioplasty was associated with a significant reduction in total stroke (0.7% vs 2.0%; P=.007) and hemorrhagic stroke (0.1% vs 1.1%; P<.001).

Conclusions.
—Based on outcomes at hospital discharge or 30 days, primary angioplasty appears to be superior to thrombolytic therapy for treatment of patients with acute myocardial infarction, with the proviso that success rates for angioplasty are as good as those achieved in these trials. Data evaluating longer-term outcomes, operator experience, and time delay before treatment are needed before primary angioplasty can be universally recommended as the preferred treatment.

Author Affiliations
From the Heart and Vascular Institute, Henry Ford Health System, Detroit, Mich (Dr Weaver); National Health and Medical Research Council Clinical Trials Centre, Sydney, Australia (Dr Simes); Hospital Clinico y Provincial, Barcelona, Spain (Dr Betriu); William Beaumont Hospital, Royal Oak, Mich (Dr Grines); Ziekenhuis De Weezenlanden, Zwolle, the Netherlands (Dr Zijlstra); Hospital General Gregorio Maranon, Madrid, Spain (Dr Garcia); Hospital Italiano de Buenos Aires, Buenos Aires, Argentina (Dr Grinfeld); Mayo Clinic, Rochester, Minn (Dr Gibbons); Unicor Hospital, São Paulo, Brazil (Dr Ribeiro); Spokane Heart Research Foundation, Spokane, Wash (Dr DeWood); and Ospedale Santa Croce, Cuneo, Italy (Dr Ribichini).

Footnotes
W. Douglas Weaver, received research grants from Guidant Corporation and Genentech; Amadeo Betrui, MD, serves as an advisory board member for Bard-USCI Boston Scientific; Cindy L. Grines, MD, has received research grants from Guidant and Scimed; Eulogio Garcia, MD, has received research grants from Guidant Corporation and Genentech; Raymond J. Gibbons, MD, has received research grants from Glaxo-Wellcome, Dupont Corporation, and Merck; and Flavio Ribichini, MD, has received research grants from Guidant Corporation and Genentech.

Reprints: W. Douglas Weaver, MD, Henry Ford Heart and Vascular Institute (K-14), 2799 W Grand Blvd, Detroit, MI 48202 (e-mail: wweaver1@hfhs.org).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

2009 ACCF/AHA Focused Update on Perioperative Beta Blockade Incorporated Into the ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery
American College of Cardiology Foundation et al.
J Am Coll Cardiol 2009;54:e13-e118.
FULL TEXT  

2009 ACCF/AHA Focused Update on Perioperative Beta Blockade Incorporated Into the ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines
2007 WRITING COMMITTEE MEMBERS et al.
Circulation 2009;120:e169-e276.
FULL TEXT  

Outcomes Among Patients With ST-Segment-Elevation Myocardial Infarction Presenting to Interventional Hospitals With and Without On-Site Cardiac Surgery
Pride et al.
Circ Cardiovasc Qual Outcomes 2009;2:574-582.
ABSTRACT | FULL TEXT  

Ephedrine-Induced Acute Myocardial Infarction in a Young Athlete: A Case of Thrombus Management
Kranjec et al.
ANGIOLOGY 2009;60:254-258.
ABSTRACT  

Off-pump versus on-pump myocardial revascularization in patients with ST-segment elevation myocardial infarction: a randomized trial.
Fattouch et al.
J. Thorac. Cardiovasc. Surg. 2009;137:650-656.
ABSTRACT | FULL TEXT  

Impact of plaque components on no-reflow phenomenon after stent deployment in patients with acute coronary syndrome: a virtual histology-intravascular ultrasound analysis
Hong et al.
Eur Heart J 2009;0:ehp034v1-8.
ABSTRACT | FULL TEXT  

Does Kidney Function Alter the Benefit of Reperfusion Therapy for ST-Segment Elevation Myocardial Infarction?
Berger and Best
J Am Coll Cardiol Intv 2009;2:34-36.
FULL TEXT  

Pharmacological Intervention for Prevention of Left Ventricular Remodeling and Improving Prognosis in Myocardial Infarction
Ishii et al.
Circulation 2008;118:2710-2718.
FULL TEXT  

Predictors of in-hospital mortality for patients admitted with ST-elevation myocardial infarction: a real-world study using the Myocardial Infarction National Audit Project (MINAP) database
Gale et al.
Heart 2008;94:1407-1412.
ABSTRACT | FULL TEXT  

Reduced-Dose Fibrinolytic Acceleration of ST-Segment Elevation Myocardial Infarction Treatment Coupled With Urgent Percutaneous Coronary Intervention Compared to Primary Percutaneous Coronary Intervention Alone: Results of the AMICO (Alliance for Myocardial Infarction Care Optimization) Registry
Denktas et al.
J Am Coll Cardiol Intv 2008;1:504-510.
ABSTRACT | FULL TEXT  

Cost-Effectiveness of Percutaneous Coronary Intervention in Optimally Treated Stable Coronary Patients
Weintraub et al.
Circ Cardiovasc Qual Outcomes 2008;1:12-20.
ABSTRACT | FULL TEXT  

Effect of PCI on Quality of Life in Patients with Stable Coronary Disease
Weintraub et al.
NEJM 2008;359:677-687.
ABSTRACT | FULL TEXT  

Acute ST-Segment Elevation Myocardial Infarction: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition)
Goodman et al.
Chest 2008;133:708S-775S.
ABSTRACT | FULL TEXT  

Facilitated PCI in Patients with ST-Elevation Myocardial Infarction
Ellis et al.
NEJM 2008;358:2205-2217.
ABSTRACT | FULL TEXT  

Thrombolysis or primary angioplasty? Reperfusion therapy for myocardial infarction in the UK
Ratcliffe and Pepper
Postgrad. Med. J. 2008;84:73-77.
ABSTRACT | FULL TEXT  

Myocardial Revascularization with Percutaneous Devices
Wilson and Willerson
Card Surg Adult 2008;3:573-598.
FULL TEXT  

Randomised comparison of femoral versus radial approach for percutaneous coronary intervention using abciximab in acute myocardial infarction: results of the FARMI Trial
Brasselet et al.
Heart 2007;93:1556-1561.
ABSTRACT | FULL TEXT  

ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery) Developed in Collaboration With the American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, and Society for Vascular Surgery
Fleisher et al.
J Am Coll Cardiol 2007;50:e159-e242.
FULL TEXT  

ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery)
Fleisher et al.
Circulation 2007;116:e418-e500.
FULL TEXT  

A Regional System to Provide Timely Access to Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction
Henry et al.
Circulation 2007;116:721-728.
ABSTRACT | FULL TEXT  

Cardiologists' Use of Percutaneous Coronary Interventions for Stable Coronary Artery Disease
Lin et al.
Arch Intern Med 2007;167:1604-1609.
ABSTRACT | FULL TEXT  

Expedited transfer for primary percutaneous coronary intervention: a program evaluation
de Villiers et al.
CMAJ 2007;176:1833-1838.
ABSTRACT | FULL TEXT  

Acute Coronary Care in the Elderly, Part II: ST-Segment-Elevation Myocardial Infarction: A Scientific Statement for Healthcare Professionals From the American Heart Association Council on Clinical Cardiology: In Collaboration With the Society of Geriatric Cardiology
Alexander et al.
Circulation 2007;115:2570-2589.
ABSTRACT | FULL TEXT  

Bleeding and blood transfusion issues in patients with non-ST-segment elevation acute coronary syndromes
Rao et al.
Eur Heart J 2007;28:1193-1204.
ABSTRACT | FULL TEXT  

Primary angioplasty vs. early routine post-fibrinolysis angioplasty for acute myocardial infarction with ST-segment elevation: the GRACIA-2 non-inferiority, randomized, controlled trial
Fernandez-Aviles et al.
Eur Heart J 2007;28:949-960.
ABSTRACT | FULL TEXT  

The Impact of Percutaneous Coronary Interventions on Outcomes for Acute Myocardial Infarction in Pennsylvania
Hollenbeak et al.
American Journal of Medical Quality 2007;22:85-94.
ABSTRACT  

Reducing the Door-to-Balloon Time for Myocardial Infarction with ST-Segment Elevation
Moscucci and Eagle
NEJM 2006;355:2364-2365.
FULL TEXT  

Paclitaxel-Eluting versus Uncoated Stents in Primary Percutaneous Coronary Intervention
Laarman et al.
NEJM 2006;355:1105-1113.
ABSTRACT | FULL TEXT  

Rheolytic Thrombectomy With Percutaneous Coronary Intervention for Infarct Size Reduction in Acute Myocardial Infarction: 30-Day Results From a Multicenter Randomized Study
Ali et al.
J Am Coll Cardiol 2006;48:244-252.
ABSTRACT | FULL TEXT  

Fondaparinux in ST-Segment Elevation Myocardial Infarction: The Drug, the Strategy, the Environment, or All of the Above?
Califf
JAMA 2006;295:1579-1580.
FULL TEXT  

ST-Segment Elevation Myocardial Infarction: Recommendations on Triage of Patients to Heart Attack Centers: Is it Time for a National Policy for the Treatment of ST-Segment Elevation Myocardial Infarction?
Henry et al.
J Am Coll Cardiol 2006;47:1339-1345.
ABSTRACT | FULL TEXT  

Does time matter? A pooled analysis of randomized clinical trials comparing primary percutaneous coronary intervention and in-hospital fibrinolysis in acute myocardial infarction patients
Boersma and The Primary Coronary Angioplasty vs. Thrombolysis
Eur Heart J 2006;27:779-788.
ABSTRACT | FULL TEXT  

Driving Times and Distances to Hospitals With Percutaneous Coronary Intervention in the United States: Implications for Prehospital Triage of Patients With ST-Elevation Myocardial Infarction
Nallamothu et al.
Circulation 2006;113:1189-1195.
ABSTRACT | FULL TEXT  

Door-to-Balloon Time in Primary Percutaneous Coronary Intervention: Is the 90-Minute Gold Standard an Unreachable Chimera?
Moscucci and Eagle
Circulation 2006;113:1048-1050.
FULL TEXT  

Primary percutaneous coronary intervention versus thrombolytic treatment: long term follow up according to infarct location
Henriques et al.
Heart 2006;92:75-79.
ABSTRACT | FULL TEXT  

Part 8: Stabilization of the Patient With Acute Coronary Syndromes
Circulation 2005;112:IV-89-IV-110.
FULL TEXT  

Reducing the Risk of Emergency Bypass Surgery for Failed Percutaneous Coronary Interventions
Bittl
J Am Coll Cardiol 2005;46:2010-2012.
FULL TEXT  

Recent advances in primary percutaneous intervention for acute myocardial infarction
Smith et al.
Heart 2005;91:1533-1536.
FULL TEXT  

Percutaneous coronary intervention: recommendations for good practice and training
Dawkins et al.
Heart 2005;91:vi1-vi27.
ABSTRACT | FULL TEXT  

Part 5: Acute Coronary Syndromes
Circulation 2005;112:III-55-III-72.
FULL TEXT  

The Influence of Race on Health Status Outcomes One Year After an Acute Coronary Syndrome
Spertus et al.
J Am Coll Cardiol 2005;46:1838-1844.
ABSTRACT | FULL TEXT  

Effects of Percutaneous Coronary Thrombectomywith the X-Sizer Catheter on Epicardial Flow and Microvascular Function in Acute Coronary Syndromes
Bilge et al.
CLIN APPL THROMB HEMOST 2005;11:461-466.
ABSTRACT  

In-hospital time to treatment of patients with acute ST elevation myocardial infarction treated with primary angioplasty: determinants and outcome. Results from the registry of percutaneous coronary interventions in acute myocardial infarction of the Arbeitsgemeinschaft Leitender Kardiologischer Krankenhausarzte
Zahn et al.
Heart 2005;91:1041-1046.
ABSTRACT | FULL TEXT  

The changing face of acute myocardial infarction
Danchin
Heart 2005;91:705-706.
ABSTRACT | FULL TEXT  

Acute myocardial infarction: the case for pre-hospital thrombolysis with or without percutaneous coronary intervention
Schofield
Heart 2005;91:iii7-iii11.
FULL TEXT  

Contemporary management of acute coronary syndrome
Large
Postgrad. Med. J. 2005;81:217-222.
ABSTRACT | FULL TEXT  

Times to Treatment in Transfer Patients Undergoing Primary Percutaneous Coronary Intervention in the United States: National Registry of Myocardial Infarction (NRMI)-3/4 Analysis
Nallamothu et al.
Circulation 2005;111:761-767.
ABSTRACT | FULL TEXT  

Excimer Laser Coronary Angioplasty in Acute Myocardial Infarction
Ilkay et al.
Asian Cardiovasc. Thorac. Ann. 2004;12:291-295.
ABSTRACT | FULL TEXT  

Is Onsite Surgery Backup Necessary for Percutaneous Coronary Interventions?
Weaver
JAMA 2004;292:2014-2016.
FULL TEXT  

Long-Term Mortality of Patients With Acute Myocardial Infarction in the United States and Canada: Comparison of Patients Enrolled in Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries (GUSTO)-I
Kaul et al.
Circulation 2004;110:1754-1760.
ABSTRACT | FULL TEXT  

Efficacy of Coronary Angioplasty Following Conventional Coronary Thrombolysis in Patients with Acute Myocardial Infarction
Hayashi et al.
ANGIOLOGY 2004;55:507-515.
ABSTRACT  

Zero Tolerance for Physical Restraints: Difficult But Not Impossible
Flaherty
Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2004;59:M919-M920.
FULL TEXT  

Percutaneous Coronary Intervention for ST-Segment and Non-ST-Segment Elevation Myocardial Infarction at Hospitals With and Without On-site Cardiac Surgical Capability
Singh et al.
Mayo Clin Proc. 2004;79:738-744.
ABSTRACT  

Imaging techniques for the assessment of myocardial hibernation: Report of a Study Group of the European Society of Cardiology
Underwood et al.
Eur Heart J 2004;25:815-836.
ABSTRACT | FULL TEXT  

Acute coronary syndromes and diabetes mellitus
Trichon and Roe
Diabetes and Vascular Disease Research 2004;1:23-32.
ABSTRACT  

Characteristics of cerebrovascular accidents after percutaneous coronary interventions
Dukkipati et al.
J Am Coll Cardiol 2004;43:1161-1167.
ABSTRACT | FULL TEXT  

A randomized trial comparing myocardial salvage achieved by coronary stenting versus balloon angioplasty in patients with acute myocardial infarction considered ineligible for reperfusion therapy
Kastrati et al.
J Am Coll Cardiol 2004;43:734-741.
ABSTRACT | FULL TEXT  

Update in Hospital Medicine
Auerbach and Kleinbart
ANN INTERN MED 2004;140:363-369.
FULL TEXT  

Coupling Drug and Catheter Therapy for Myocardial Infarction
Lincoff
JAMA 2004;291:1000-1002.
FULL TEXT  

Cost-Effectiveness of Coronary Stenting and Abciximab for Patients With Acute Myocardial Infarction: Results From the CADILLAC (Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications) Trial
Bakhai et al.
Circulation 2003;108:2857-2863.
ABSTRACT | FULL TEXT  

Impact of Time to Treatment on Mortality After Prehospital Fibrinolysis or Primary Angioplasty: Data From the CAPTIM Randomized Clinical Trial
Steg et al.
Circulation 2003;108:2851-2856.
ABSTRACT | FULL TEXT  

Modulation of calcium transport improves myocardial contractility and enzyme profiles after prolonged ischemia-reperfusion
Yarbrough et al.
Ann. Thorac. Surg. 2003;76:2054-2061.
ABSTRACT | FULL TEXT  

Direct inhibition of the sodium/hydrogen exchanger after prolonged regional ischemia improves contractility on reperfusion independent of myocardial viability
Yarbrough et al.
J. Thorac. Cardiovasc. Surg. 2003;126:1489-1497.
ABSTRACT | FULL TEXT  

Assessment of the Patient with Hyperacute Stroke: Imaging and Therapy
Provenzale et al.
Radiology 2003;229:347-359.
ABSTRACT | FULL TEXT  

Prospective Evaluation of Clinical Outcomes After Acute ST-Elevation Myocardial Infarction in Patients Who Are Ineligible for Reperfusion Therapy: Preliminary Results From the TETAMI Registry and Randomized Trial
Cohen et al.
Circulation 2003;108:III-14-21.
ABSTRACT | FULL TEXT  

All Hospitals Are Not Equal for Treatment of Patients With Acute Myocardial Infarction
Weaver
Circulation 2003;108:1768-1771.
FULL TEXT  

Transfer for Primary Angioplasty Versus Immediate Thrombolysis in Acute Myocardial Infarction: A Meta-Analysis
Dalby et al.
Circulation 2003;108:1809-1814.
ABSTRACT | FULL TEXT  

A critical amendment to the Meta-analysis of clinical trials comparing Thrombolysis with Primary Angioplasty
Thimme
Eur Heart J 2003;24:1898-1898.
FULL TEXT  

Counterintuitive contributionsto the care of myocardialinfarction and theneed for randomized trials
Morrison
J Am Coll Cardiol 2003;42:978-980.
FULL TEXT  

Therapy-Dependent Influence of Time-to-Treatment Interval on Myocardial Salvage in Patients With Acute Myocardial Infarction Treated With Coronary Artery Stenting or Thrombolysis
Schomig et al.
Circulation 2003;108:1084-1088.
ABSTRACT | FULL TEXT  

Beneficial effects of immediate stenting after thrombolysis in acute myocardial infarction
Scheller et al.
J Am Coll Cardiol 2003;42:634-641.
ABSTRACT | FULL TEXT  

Evolving strategies in the treatment of acute myocardial infarction in the community hospital setting
McKay
J Am Coll Cardiol 2003;42:642-645.
FULL TEXT  

Synergistic treatment of ST-segmentelevation myocardial infarction with pharmacoinvasive recanalization
Dauerman and Sobel
J Am Coll Cardiol 2003;42:646-651.
ABSTRACT | FULL TEXT  

Primary angioplasty for ST-segment elevation myocardial infarction: Ready for prime time?
Natarajan and Yusuf
CMAJ 2003;169:32-35.
FULL TEXT  

Rising to the challenge: transforming the treatment of ST-segment elevation myocardial infarction
Ghali et al.
CMAJ 2003;169:35-37.
FULL TEXT  

Glycoprotein IIb/IIIa inhibition in the setting of acute ST-segment elevation myocardial infarction
Eisenberg and Jamal
J Am Coll Cardiol 2003;42:1-6.
ABSTRACT | FULL TEXT  

Determinants of treatment strategies and survival in acute myocardial infarction: a population-based study in the Florence district, Italy: Results of the acute myocardial infarction Florence registry (AMI-Florence),
Buiatti et al.
Eur Heart J 2003;24:1195-1203.
ABSTRACT | FULL TEXT  

The prognostic importance of heart failure and age in patients treated with primary angioplasty
Henriques et al.
Eur J Heart Fail 2003;5:291-294.
ABSTRACT | FULL TEXT  

Regionalization of Care for Acute Ischemic Heart Disease: A Call for Specialized Centers
Topol and Kereiakes
Circulation 2003;107:1463-1466.
FULL TEXT  

Angioplasty vs thrombolysis for acute myocardial infarction: a quantitative overview of the effects of interhospital transportation
Zijlstra
Eur Heart J 2003;24:21-23.
FULL TEXT  

Management of acute myocardial infarction in patients presenting with ST-segment elevation
The Task Force on the Management of Acute Myocardi et al.
Eur Heart J 2003;24:28-66.
FULL TEXT  

Long distance transport for primary angioplasty vs immediate thrombolysis in acute myocardial infarction: Final results of the randomized national multicentre trial--PRAGUE-2
Widimsky et al.
Eur Heart J 2003;24:94-104.
ABSTRACT | FULL TEXT  

Transfer for primary angioplasty: who and how?
Dalby and Montalescot
Heart 2002;88:570-572.
ABSTRACT | FULL TEXT  

JournalScan
Malik
Heart 2002;88:671-672.
FULL TEXT  

How to best counteract the enemies? By ensuring adequate oxygen delivery
Neumann and Jander
Eur Heart J Suppl 2002;4:G35-G42.
ABSTRACT  

Plaque Gruel of Atheromatous Coronary Lesion May Contribute to the No-Reflow Phenomenon in Patients With Acute Coronary Syndrome
Kotani et al.
Circulation 2002;106:1672-1677.
ABSTRACT | FULL TEXT  

Patient outcomes after fibrinolytic therapy for acute myocardial infarction at hospitals with and without coronary revascularization capability
Mehta et al.
J Am Coll Cardiol 2002;40:1034-1040.
ABSTRACT | FULL TEXT  

Clinical outcomes of patients with diabetes mellitus and acute myocardial infarction treated with primary angioplasty or fibrinolysis
Hsu et al.
Heart 2002;88:260-265.
ABSTRACT | FULL TEXT  

ACUTE MYOCARDIAL INFARCTION: REPERFUSION TREATMENT
Ribichini and Wijns
Heart 2002;88:298-305.
FULL TEXT  

Prognostic Implications of Abnormalities in Renal Function in Patients With Acute Coronary Syndromes
Al Suwaidi et al.
Circulation 2002;106:974-980.
ABSTRACT | FULL TEXT  

Low molecular weight heparin: a bridge over troubled water
Verheugt
Eur Heart J 2002;23:1144-1146.
FULL TEXT  

Late is perhaps not ... too late for primary PCI in acute myocardial infarction
Bertrand and McFadden
Eur Heart J 2002;23:1146-1148.
FULL TEXT