BACKGROUND: Fibrinolytic therapy remains the reperfusion strategy of choice for many regions treating @entity1 presenting with @entity583 ( @entity583 ). However, limited data exist regarding the pattern of use of rescue percutaneous coronary intervention (PCI) in @entity1 with @entity583 who failed fibrinolysis, factors associated with its use, and its impact on long-term outcomes. METHODS: Observational analysis of a population-based cohort was done, which included 2,953 @entity1 with @entity583 hospitalized from 2004 to 2005 in Ontario, Canada. Failed fibrinolysis was defined as <50% ST-segment resolution on follow-up electrocardiogram at 60 to 90 minutes after fibrinolysis. The main outcome of measure was @entity204 or repeat hospitalization for @entity1187 at 4 years. RESULTS: Among the 1,517 @entity1 who received fibrinolytic therapy, 611 @entity1 (40.3%) failed fibrinolysis. Of these, rescue PCI was performed in 212 @entity1 (34.7%); conservative management, in 373 @entity1 (61.1%); and repeat fibrinolysis, in 26 @entity1 (4.3%). Initial presentation to a PCI hospital was the strongest predictor of rescue PCI use (odds ratio 3.7, 95% CI 2.2-6.0). At 4-year follow-up, the primary end point occurred in 24.5% of @entity1 who received rescue PCI and 36.5% in @entity1 with no rescue PCI (adjusted hazard ratio 0.69, 95% CI 0.49-0.96). This difference was attributable mainly to a significant reduction in @entity204 favoring rescue PCI @entity1 (hazard ratio 0.60, 95% CI 0.38-0.94). CONCLUSIONS: Rescue PCI was associated with significantly lower risk of long-term adverse outcomes for @entity1 with @entity583 who failed fibrinolytic therapy. However, rescue PCI is substantially underused in clinical practice.

Rescue percutaneous coronary interventions for failed fibrinolytic therapy in XXXX : a population-based study.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity583 :: ('MESH:D009203', 'Disease') :: ['STEMI', 'ST-segment elevation myocardial infarction'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death'] @entity1187 :: ('MESH:D054058', 'Disease') :: ['acute coronary syndrome']
@entity583 :: (MESH:D009203,Disease) :: ['ST-segment elevation myocardial infarction']
