%0 Journal Article
%T A comparison of outcomes of routine early angiography versus delayed ischemia-guided angiography after thrombolytic therapy in ST segment-elevation myocardial infarction
%A HA Basiri
%A R Kiani
%A S Abdi
%A A Zahedmehr
%J Iranian Cardiovascular Research Journal
%D 2011
%I 
%X Background: Thrombolytic therapy continues to be the common treatmentin acute ST elevation myocardialinfarction in the majority of heart centers worldwide. However, thrombolytictherapy is associated with highre-occlusion and re-infarction rates. So, most patients now undergo earlydiagnostic angiography and possiblyangioplasty of the culprit artery but the controversy about the timing ofangiography after thrombolysis continuesto remain unresolved. In this prospective cohort study, we compared the outcomeof early invasive strategyversus delayed invasive approach in ST-elevation MI patients who had receivedsuccessful thrombolytictherapy. Primary endpoint of the study was Major Adverse Cardiovascular Eventsor MACE ( the combined rateof death, re-infarction, major bleeding and cerebrovasular events. Secondaryendpoints were re-infarction andre-hospitalization rate.Method: The study comprised 142 patients of which 87 had a routineangiography in less than 10 days of acuteevent and 55 underwent ischemia-guided angiography after 10 days of index event.Stenting of the culprit vesselwas done in 60% of the routine angiography group and 63% of the ischemia-guidedgroup. The patients werefollowed for 8.8 ¡À 2.8 months after the index event.Results: The primary endpoint occurred in 6.9% of routine angiographypatients and 10.9% of the control group(P= 0.4). The rate of re-infarction was significantly higher in the delayedinvasive arm than routine early invasivearm (10.9% vs. 1.1, P:0.01),and mostly occurring before angiography.Conclusion: routine angiography as soon as possible after thrombolysiscan reduce re-infarction and was notassociated with any increased risk of adverse events in our study.
%K Coronary Angiography
%K Myocardial Infarction
%K Thrombolytic Therapy
%U http://icrj.ir/UI/Pblc/..%5C..%5CFiles%5CAuthArts%5C1260+.PDF