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European Heart Journal 2004 25(7):540-542; doi:10.1016/j.ehj.2004.01.022
Copyright © 2004 by the European Society of Cardiology.
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Current opinion

Reflections on the Danish Revolution

Mark C Petriea

a Department of Cardiology, Western Infirmary of Glasgow, Glasgow, UK

Felix Zijlstrab,*

b Department of Cardiology, Academic Hospital Groningen, Groningen, The Netherlands

* Corresponding author. Present address: Thorax-Centre, P.O. Box 30001, 9700RB Groningen, The Netherlands.
E-mail address: mcp1n@udcf.gla.ac.uk

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

Cardiologists have for some time accepted that primary angioplasty, at least in the best hands, results in improved outcomes in patients with ST segment elevation myocardial infarction when compared to thrombolysis. An impasse had, however, arisen in the cardiology community. Primary angioplasty was regarded as the treatment that we would like to receive, and to offer, but the results of the well conducted trials have been regarded as impossible to translate into routine clinical practice. Arguments against the routine use of primary angioplasty had centred on the assumption that these results were only achievable in high volume centres manned by high quality staff. This year two landmark publications have forced us to radically reassess the role of primary angioplasty in the management of acute myocardial infarction.

The first was a Lancet meta-analysis of 23 trials that demonstrated in the . . . [Full Text of this Article]

What are the logistical considerations?

Timing of primary angioplasty

Is there corroborating evidence?

Can we afford not proceed with the implementation of primary angioplasty?

Should we delay to find out what might be the optimal combination of reperfusion strategies in acute myocardial infarction?

Why is primary angioplasty better for patients with acute myocardial infarction than thrombolysis?


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