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Percutaneous transluminal coronary angioplasty is an effective treatment for myocardial infarction; it is used in two ways:
Comparing angioplasty and thrombolysis as the primary interventions, angioplasty is (1):
A commentary (2) states that suggests that patient groups where primary percutaneous coronary intervention (PCI) may be particularly beneficial are elderly patients, patients with heart failure or cardiogenic shock or those patients who present late. It was suggested that fibrinolysis may be preferable to PCI if symptom duration was < 2 hours - in this scenario early reperfusion may salvage substantial myocardium.
If there hase been failure of thrombolysis in ST elevation myocardial infarction:
Ultimately, the decision to provide angioplasty is likely to reside with the availability of resources. Thrombolytic drugs are widely accessible in all UK hospitals, whereas coronary angioplasty facilities, and prerequisite angiography facilities, are only sited in specialist centres.
Bivalirudin in combination with aspirin and clopidogrel is recommended for the treatment of adults with ST-segment-elevation myocardial infarction undergoing primary percutaneous coronary intervention (4).
Reference:
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