Providing best practices for the management of ST-segment elevation myocardial infarction (STEMI): Pharmacoinvasive strategies

Abstract

Although primary PCI remains the preferred strategy for the treatment of STEMI, the lack of expanded PCI centers and prolonged transfer times have resulted in delayed reperfusion and thus increased mortality. A pharmacoinvasive strategy involving immediate fibrinolysis followed by transfer to a PCI center to perform angiography (and PCI of infarct-related arteries) within 2 and 24 hours after successful fibrinolysis offers immediate reperfusion and better outcomes in patients in whom primary PCI could not be achieved in a timely manner without an increase in bleeding complications. The article summarizes the evidence for this approach in terms of efficacy and safety.