Abstract
The important component in patients` treatment with ST-elevation myocardial infarction
(STEMI) is urgent myocardial revascularization with thrombolytic therapy (TLT) or percutaneous
coronary intervention (PCI). In which thrombolytic therapy (TT) or percutaneous coronarography
intervention (PCI) are used. To date, numerous studies have established that in
ideal conditions of medical care organization for patients with STEMI, primary PCI has
advantages over TLT, according to the efficacy of myocardial revascularization and the duration
of using this method. Possible term of effective TLT application is 12 hours from the beginning
of the onset while PCI terms can be limited only by its presence and medical conditions.
Clinical and prognostic efficiency of PCI was shown in such category of patients according to
the time from the beginning of the onset up to 2 - 3 days, but the sooner it is used the better.
According to the outcomes, it is necessary to use PCI in a large number of patients with STEMI
including those who underwent TLT. Pharmaco-invasive reperfusion strategy became a frequent
practice in patients with STEMI. TLT is performed in the shortest time after the onset
and contact with patient. Coronary angiography and PCI are performed within 24 hours in
presence of hemodynamically significant lesion of infarct-related artery. Re-thrombosis of
coronary artery and hemorrhagic complications are the alarming risk factors which are
increased in case of immediate PCI after TLT. The risk is neutralized within several hours after
TLT. Results of pharmaco-invasive strategy are consistent with the results of primary PCI not
only in a short-term period, but within several months after the procedure.
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