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Joel M. Gore, MD; James E. Dalen, MD

JAMA. 1993;270(2):190-192.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Major advances in the treatment of cardiac diseases continue at a rapid rate. Clinicians caring for patients with heart disease are bombarded with new and often differing treatment options.

Intravenous thrombolytic therapy has led to a dramatic improvement in the outlook for patients with acute myocardial infarction (MI). However, reocclusion of the infarct-related artery occurs in some patients, leading to increased morbidity and mortality. Early trials of routine angioplasty immediately following thrombolytic therapy failed to show benefit compared with a more conservative approach in which angioplasty was only performed as clinically indicated.

Three studies published at the same time in the same journal^1-3 have pointed the pendulum back toward immediate angioplasty. In these prospective randomized trials, subjects with evolving acute MI either underwent immediate percutaneous transluminal coronary angioplasty (PTCA) or received intravenous thrombolytic therapy within 12 to 24 hours of onset of chest pain, followed by 2 to 5 . . . [Full Text PDF of this Article]

Author Affiliations
University of Massachusetts Medical School, Worcester; University of Arizona Health Sciences Center, Tucson

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