Nearly two decades after clinical trials established that fibrinolytictherapy for acute myocardial infarction preserves left ventricularfunction and reduces mortality, there is evidence that mechanicalreperfusion therapy is superior in reducing the rates of death,reinfarction, intracranial bleeding, reocclusion of the infarct-relatedartery, and recurrent ischemia. Initially introduced as an alternativeto fibrinolytic therapy (to circumvent contraindications toits use and the risk of intracranial bleeding), primary percutaneouscoronary intervention is now increasingly recognized as thereperfusion therapy of choice. The ability to restore robustcoronary flow promptly in more than 90 percent of patients andthe nearly linear . . . [Full Text of this Article]
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From the Cardiology Section, Department of Medicine, Boston University Medical Center, Boston.
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