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European Heart Journal Advance Access originally published online on April 19, 2006
European Heart Journal 2006 27(10):1131-1133; doi:10.1093/eurheartj/ehi740
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© The European Society of Cardiology 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Should intravenous thrombolysis keep a place in the treatment of acute ST-elevation myocardial infarction?

Nicolas Danchin*

Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015 Paris, France

* Corresponding author. Tel: +33 156 09 37 14; fax: +33 156 09 25 72. E-mail address: nicolas.danchin@egp.ap-hop-paris.fr

This editorial refers to ‘Pre-hospital thrombolysis delivered by paramedics is associated with reduced time delay and mortality in ambulance-transported real-life patients with ST-elevation myocardial infarction’{dagger} by E. Björklund et al., on page 1146

The first 10% of the full text of this article appears below.

Following the recognition of the role of intracoronary thrombus in the pathogenesis of acute myocardial infarction, intracoronary, then intravenous thrombolysis have been documented as the first methods capable of achieving adequate reperfusion of the jeopardized myocardium. The clinical consequence of early reperfusion was a reduction in mortality rates at the acute stage. Subsequently, coronary angioplasty has shown its capacity to reopen recently occluded arteries, and the direct comparison of intravenous thrombolysis with percutaneous coronary angioplasty performed in an ‘ideal’ setting has consistently shown the superiority of the mechanical compared with the pharmacological approach. The most recent randomized trials comparing both modes of reperfusion therapy have shown that better clinical results were achieved using coronary angioplasty, even when the patients had to be transferred from an initial institution to another one, with the capability to perform . . . [Full Text of this Article]


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Related articles in EHJ:

Pre-hospital thrombolysis delivered by paramedics is associated with reduced time delay and mortality in ambulance-transported real-life patients with ST-elevation myocardial infarction
Erik Björklund, Ulf Stenestrand, Johan Lindbäck, Leif Svensson, Lars Wallentin, Bertil Lindahl, and on behalf of the RIKS-HIA Investigators
EHJ 2006 27: 1146-1152. [Abstract] [FREE Full Text]