Coronary Angiography after Thrombolytic Therapy for Acute Myocardial Infarction
Authors: Eric J. Topol, David R. Holmes, William J. Rogers
Journal: Annals of Internal Medicine (1991)

Reviews15 May 1991Coronary Angiography after Thrombolytic Therapy for Acute Myocardial InfarctionEric J. Topol, MD, David R. Holmes, MD, William J. Rogers, MDEric J. Topol, MD, David R. Holmes, MD, William J. Rogers, MDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-114-10-877 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptPurpose: To review the status of emergency, urgent, routine, and selective angiography after intravenous thrombolytic therapy.Data Sources: Relevant English-language articles published from January 1985 to July 1990 were identified through MEDLINE.Study Selection: For emergency angiography, four major randomized studies were reviewed and data from nine studies that incorporated rescue coronary angioplasty were pooled for metaanalysis. For urgent angiography, two controlled trials were reviewed. Comparisons of routine and selective angiography were done using data from two dedicated, large-scale, controlled trials and the ancillary findings of four other studies of reperfusion that incorporated angiography.Data Extraction: The review emphasizes the findings from multicenter, randomized, controlled trials.Data Synthesis: Emergency coronary angiography is done pri marily in preparation for primary or rescue angioplasty; the value of rescue angioplasty has yet to be assessed in a randomized trial, but technical success and reocclusion improve significantly after therapy with nonspecific plasminogen activators compared with relatively specific agents (success rate, 86% compared with 75%, respectively; P = 0. 03; reocclusion rate, 10.9% compared with 26.8%, respectively; P < 0.001). Urgent coronary angiography has value for treating recurrent ischemia, but patients who develop this complication after thrombolysis are likely to have a suboptimal outcome despite aggressive care. Studies support the use of either selective or routine angiography in uncomplicated patients after thrombolytic therapy; either approach is acceptable, but the former is more practical and may prove to be cost effective.Conclusions:Optimal follow-up for patients with evolving myocardial infarction who receive thrombolysis may incorporate coronary angiography at various stages. Although our ability to noninvasively detect reperfusion, reocclusion, or viable but ischemic myocardium is limited at present, available data may assist in selecting a catheterization strategy....References1. . Effectiveness of intravenous thrombolytic treatment in acute myocardial infarction. Lancet. 1986;1:397-402. MedlineGoogle Scholar2. . Randomised trial of intravenous streptokinase, oral aspirin, both, or neither among 17,187 cases of suspected acute myocardial infarction: ISIS-2. Lancet. 1988;2:349-60. MedlineGoogle Scholar3. . Effect of intravenous APSAC on mortality after acute myocardial infarction: preliminary report of a place-bo-controlled clinical trial. Lancet. 1988;1:545-9. MedlineGoogle Scholar4. Wilcox R, von der Lippe G, Olsson C, Jensen G, Skene A, and Hampton J. Trial of tissue plasminogen activator for mortality reduction in acute myocardial infarction. Anglo-Scandinavian Study of Early Thrombolysis (ASSET). Lancet. 1988;2:525-30. CrossrefMedlineGoogle Scholar5. Goa K, Henwood J, Stolz J, Langley M, and Clissold S. Intravenous streptokinase. A reappraisal of its therapeutic use in acute myocardial infarction. Drugs. 1990;39:693-719. CrossrefMedlineGoogle Scholar6. Topol E, CaIhY R, and George B. A randomized trial of immediate versus delayed elective angioplasty after intravenous tissue plasminogen activator in acute myocardial infarction. N Engl J Med. 1987;317:581-8. CrossrefMedlineGoogle Scholar7. Simoons M, Arnold A, and Betriu A. Thrombolysis with tissue plasminogen activator in acute myocardial infarction: no additional benefit from immediate percutaneous coronary angioplasty. Lancet. 1988;1:197-203. CrossrefMedlineGoogle Scholar8. . Immediate vs delayed catheterization and angioplasty following thrombolytic therapy for acute myocardial infarction. JAMA. 1988;260:2849-58. CrossrefMedlineGoogle Scholar9. Topol E, Bates E, and Walton J. Community hospital administration of intravenous tissue plasminogen activator in acute myocardial infarction: improved timing, thrombolytic efficacy and ventricular function. J Am Coll Cardiol. 1987;10:1173-7. CrossrefMedlineGoogle Scholar10. O'Keefe J, Rutherford B, and McConahay D. Early and late results of coronary angioplasty without antecedent thrombolytic therapy for acute myocardial infarction. Am J Cardiol. 1989;64:1221-30. CrossrefMedlineGoogle Scholar11. Erbel R, Pop T, and Henrichs K. Percutaneous transluminal coronary angioplasty after thrombolytic therapy: a prospective controlled randomized trial. J Am Coll Cardiol. 1986;8:485-95. CrossrefMedlineGoogle Scholar12. Holmes D, Smith H, and Vlietstra R. Percutaneous transluminal coronary angioplasty, alone or in combination with streptokinase therapy, during acute myocardial infarction. Mayo Clin Proc. 1985;60:449-56. CrossrefMedlineGoogle Scholar13. Prida X, Holland J, and Feldman R. Percutaneous transluminal coronary angioplasty in evolving acute myocardial infarction. Am J Cardiol. 1986;57:1069-74. CrossrefMedlineGoogle Scholar14. Rothbaum D, Linnemeier T, and Landin R. Emergency percutaneous transluminal coronary angioplasty in acute myocardial infarction: a 3 year experience. J Am Coll Cardiol. 1987;10:264-72. CrossrefMedlineGoogle Scholar15. Miller P, Brodie B, and Weintraub R. Emergency coronary angioplasty for acute myocardial infarction. Results from a community hospital. Arch Intern Med. 1987;147:1565-70. CrossrefMedlineGoogle Scholar16. Ellis S, O'Neill W, Bates E, Walton J, Nabel E, and Topol E. Coronary angioplasty as primary therapy for acute myocardial infarction 6 to 48 hours after symptom onset: report of an initial experience. J Am Coll Cardiol. 1989;13:1122-6. CrossrefMedlineGoogle Scholar17. Topol E. Coronary angioplasty for acute myocardial infarction. Ann Intern Med. 1988;109:970-80. LinkGoogle Scholar18. Califf R, O'Neil W, and Stack R. Failure of simple clinical measurements to predict perfusion status after intravenous thrombolysis. Ann Intern Med. 1988;108:658-62. LinkGoogle Scholar19. Seacord L, Abendschein D, Nohara R, Hartzler G, Sobel B, and Jaffe A. Detection of reperfusion within 1 hour after coronary recanalisation by analysis of isoforms of the MM creatine kinase isoenzyme in plasma. Fibrinolysis. 1988;2:151-6. CrossrefGoogle Scholar20. Dellborg M and Swedberg K. Dynamic QRS-complex and ST-segment vectorcardiographic monitoring in acute myocardial infarction [Abstract]. Circulation. 1989;80:11-355. Google Scholar21. Fung A, Lai P, and Topol E. Value of percutaneous transluminal coronary angioplasty after unsuccessful intravenous streptokinase therapy in acute myocardial infarction. Am J Cardiol. 1986,58:686-91. CrossrefMedlineGoogle Scholar22. Holmes D, Gersh B, and Bailey K. "Rescue" percutaneous transluminal coronary angioplasty after failed thrombolytic therapy —4 year follow-up [Abstract]. J Am Coll Cardiol. 1989;13:193A. Google Scholar23. Grines C, Nissen S, and Booth D. A new thrombolytic regimen for acute myocardial infarction using combination half dose tissue-type plasminogen activator with full dose streptokinase: a pilot study. J Am Coll Cardiol. 1989;14:573-80. CrossrefMedlineGoogle Scholar24. Grines C, Nissen S, and Booth D. A prospective, randomized trial comparing combination half dose t-PA with streptokinase to full dose t-PA in acute myocardial infarction: preliminary report [Abstract]. J Am Coll Cardiol. 1990;15:4A. CrossrefGoogle Scholar25. Topol E, Califf R, and George B. Coronary arterial thrombolysis with combined infusion of recombinant tissue-type plasminogen activator and urokinase in patients with acute myocardial infarction. Circulation. 1988;77:1100-7. CrossrefMedlineGoogle Scholar26. Califf R, Topol E, and Stack R. An evaluation of combination thrombolytic therapy and timing of cardiac catheterization in acute myocardial infarction: The TAMI 5 randomized trial. Circulation. 1991;83[In press]. CrossrefGoogle Scholar27. Bairn D, Diver D, and Knatterud G. PTCA "salvage" for thrombolytic failures—implications from TIMI H-A [Abstract]. Circulation 1988;78:11-112. Google Scholar28. O'Connor C, Mark D, and Hinohara T. Rescue coronary angioplasty after failure of intravenous streptokinase in acute myocardial infarction: in-hospital and long-term outcomes. J Inv Cardiol. 1989;1:85-95. Google Scholar29. Gacioch G and Topol E. Sudden paradoxic clinical deterioration during angioplasty of the occluded right coronary artery in acute myocardial infarction. J Am Coll Cardiol. 1989;14:1202-9. CrossrefMedlineGoogle Scholar30. Gacioch G. Rescue angioplasty for failed thrombolytic therapy: the TAMI I-IV experience [Abstract]. Circulation. 1989;80:11-625. Google Scholar31. Abbottsmith C, Topol E, and George B. Fate of patients with acute myocardial infarction with patency of the infarct-related vessel achieved with successful thrombolysis versus rescue angioplasty. J Am Coll Cardiol. 1990;16:770-8. CrossrefMedlineGoogle Scholar32. Topol E, Califf R, and George B. Can emergency coronary angiography and rescue angioplasty improve infarct vessel patency after thrombolysis? The TAMI-5 trial preliminary results [Abstract]. Circulation. 1989;80:11-418. Google Scholar33. . Randomised double-blind trial of recombinant pro-urokinase against streptokinase in acute myocardial infarction. Lancet. 1989;2:863-7. Google Scholar34. Passamani E, Hodges M, and Herman M. The Thrombolysis in Myocardial Infarction (TIMI) phase II pilot study: tissue plasminogen activator followed by percutaneous transluminal coronary angioplasty. J Am Coll Cardiol. 1987;10(Suppl B):51B-64B. CrossrefMedlineGoogle Scholar35. . Comparison of invasive and conservative strategies after treatment with intravenous tissue plasminogen activator in acute myocardial infarction. Results of the thrombolysis in myocardial infarction (TIMI) phase II trial. N Engl J Med. 1989;320: 618-27. CrossrefMedlineGoogle Scholar36. Muller D, Topol E, and Harrelson L. Failure of conservative management postthrombolysis: profile of the TAMI-5 crossover population [Abstract]. J Am Coll Cardiol. 1990;15:63A. CrossrefGoogle Scholar37. Topol E. Mechanical interventions for acute myocardial infarction. In: Topol EJ, ed. Textbook of Interventional Cardiology. Philadelphia: W. B. Saunders; 1989:269-99. Google Scholar38. Rogers W, Babb J, and Bairn D. Is pre-discharge coronary arteriography beneficial in patients with myocardial infarction treated with thrombolytic therapy? [Abstract]. J Am Coll Cardiol. 1990;15:64A. CrossrefMedlineGoogle Scholar39. Charles E, Rogers W, and Reeder G. Economic advantages of a conservative strategy for acute myocardial infarction management: rt-PA without obligatory PTCA [Abstract]. J Am Coll Cardiol 1989;13:152A. Google Scholar40. Holmes D and Topol E. Reperfusion momentum: lessons from the randomized trials of immediate coronary angioplasty for myocardial infarction. J Am Coll Cardiol. 1989;14:1572-8. CrossrefMedlineGoogle Scholar41. Rogers W, Bairn D, and Gore J. Comparison of immediate invasive, delayed invasive, and conservative strategies after tissue-type plasminogen activator. Results of the Thrombolysis in Myocardial Infarction (TIMI) Phase II-A Trial. Circulation. 1990;82: 1457-76. CrossrefGoogle Scholar42. Sleight P Do we need to intervene after thrombolysis in acute myocardial infarction? Circulation. 1990;81:1707-9. CrossrefMedlineGoogle Scholar43. de Bono D and Pocock S. The SWIFT study of intervention versus conservative management after anistreplase thrombolysis. Br Med J. 1991;302:555-60. MedlineGoogle Scholar44. Cheitlin M. The aggressive war on acute myocardial infarction: is the blitzkrieg strategy changing? JAMA. 1988;260:2894-6. CrossrefMedlineGoogle Scholar45. Schmidt W, Uebis R, and von Essen R. Residual coronary stenosis after thrombolysis with rt-PA or streptokinase: acute results and 3 weeks follow-up. Eur Heart J. 1987;8:1182-8. CrossrefMedlineGoogle Scholar46. Topol E. Thrombolytic Intervention. In: Topol EJ, ed. Textbook of Interventional Cardiology. Philadelphia: W. B. Saunders Company; 1989:76-120. Google Scholar47. Kereiakes D, Topol E, and George B. Myocardial infarction with minimal coronary atherosclerosis in the era of myocardial reperfusion. J Am Coll Cardiol. 1991;17:304-12. CrossrefMedlineGoogle Scholar48. Hochman J and Choo H. Limitation of myocardial infarct expansion by reperfusion independent of myocardial salvage. Circulation. 1987;75:299-306. CrossrefMedlineGoogle Scholar49. Hale S and Kloner R. Left ventricular topographic alterations in the completely healed rat infarct caused by early and late coronary artery reperfusion. Am Heart J. 1988;116:1508-13. CrossrefMedlineGoogle Scholar50. Jeremy R, Allman K, Bautovitch G, and Harris P. Patterns of left ventricular dilation during the six months after myocardial infarction. J Am Coll Cardiol. 1989;13:304-10. CrossrefMedlineGoogle Scholar51. Braunwald E. Myocardial reperfusion, limitation of infarct size, reduction of left ventricular dysfunction, and improved survival. Should the paradigm be expanded? Circulation. 1989;79:441-4. CrossrefMedlineGoogle Scholar52. Califf R, Topol E, and Gersh B. From myocardial salvage to patient salvage in acute myocardial infarction: the role of reperfusion therapy. J Am Coll Cardiol. 1989;14:1382-8. CrossrefMedlineGoogle Scholar53. Kersschot I, Brugada P, and Ramentol M. Effects of early reperfusion in acute myocardial infarction on arrhythmias induced by programmed stimulation: a prospective, randomized study. J Am Coll Cardiol. 1986;7:1234-42. CrossrefMedlineGoogle Scholar54. Topol E, Califf R, George B, Kereiakes D, and Lee K. Insights derived from the Thrombolysis and Angioplasty in Myocardial Infarction (TAMI) trials [Abstract]. J Am Coll Cardiol. 1989;12:24A-31A. CrossrefGoogle Scholar55. Topol E, Ellis S, and George B. The pivotal role of multivessel coronary artery disease and the remote zone in the reperfusion era [Abstract]. J Am Coll Cardiol. 1989;13:92A. MedlineGoogle Scholar56. Lee K, Sigmon K, and George B. Early and complete reperfusion—a key predictor or survival after thrombolytic therapy [Abstract]. Circulation. 1988;78:11-500. Google Scholar57. Topol E, George B, and Kereiakes D. A randomized controlled trial of intravenous tissue plasminogen activator and early intravenous heparain in acute myocardial infarction. Circulation. 1989;79: 281-6. CrossrefMedlineGoogle Scholar58. Gersh B and Robertson T. The efficacy of percutaneous transluminal coronary angioplasty (PTCA) in coronary artery disease-why we need randomized trials. In: Topol EJ, ed. Textbook of Interventional Cardiology. Philadelphia: W. B. Saunders Company; 1989:240-53. Google Scholar59. Schulman S, Achuff S, and Griffith L. Prognostic cardiac catheterization variables in survivors of acute myocardial infarction: a five year prospective study. J Am Coll Cardiol. 1988;11:1164-72. CrossrefMedlineGoogle Scholar60. Turner J, Rogers W, Mantle J, Rackley C, and Russell R. Coronary angiography soon after myocardial infarction. Chest. 1980;77:58-64. CrossrefMedlineGoogle Scholar61. Betriu A, Castaner A, and Sanz G. Angiographic findings 1 month after myocardial infarction: a prospective study of 259 survivors. Circulation. 1982;65:1099-105. CrossrefMedlineGoogle Scholar62. Ellis S, Topol E, and George B. Recurrent ischemia without warning. Analysis of risk factors for in-hospital ischemic events following successful thrombolysis with intravenous tissue plasminogen activator. Circulation. 1989;80:1159-65. CrossrefMedlineGoogle Scholar63. Little W, Constantinescu M, and Applegate R Can coronary angiography predict the site of a subsequent myocardial infarction in patients with mild-to-moderate coronary artery disease? Circulation. 1988;78:1157-66. CrossrefMedlineGoogle Scholar64. Theroux P, Waters D, Halphen C, Debaisieux J, and Mizgala H. Prognostic value of exercise testing soon after myocardial infarction. N Engl J Med. 1979;301:341-5. CrossrefMedlineGoogle Scholar65. . Evaluation of patients after recent acute myocardial infarction. Ann Intern Med. 1989;110:485-8. LinkGoogle Scholar66. Hamm L, Crow R, Stull G, and Hannan P. Safety and characteristics of exercise testing early after acute myocardial infarction. Am J Cardiol. 1989;63:1193-7. CrossrefMedlineGoogle Scholar67. Cleempoel H, Vainsel H, and Dramaix M. Limitations on the prognostic value of predischarge data after myocardial infarction. Br Heart J. 1988;60:98-103. CrossrefMedlineGoogle Scholar68. Simoons M, Vos J, and Tijssen J. Long-term benefit of early thrombolytic therapy in patients with acute myocardial infarction: 5 year follow-up of a trial conducted by the Interuniversity Cardiology Institute in the Netherlands. J Am Coll Cardiol. 1989;14:1609-15. CrossrefMedlineGoogle Scholar69. Chaitman B, Younis L, and Shaw L. Exercise ECG test results in the TIMI II trial [Abstract]. J Am Coll Cardiol. 1990;15:251A. CrossrefMedlineGoogle Scholar70. Burns R, Freeman M, and Liu P. Limitations of exercise thallium single photon tomography early after myocardial infarction [Abstract]. J Am Coll Cardiol. 1989;13:125A. Google Scholar71. Weiss A, Maddahi J, and Shah P. Exercise-induced ischemia in the streptokinase-reperfused myocardium: relationship to extent of salvaged myocardium and degree of residual coronary stenosis. Am Heart J. 1989;118:9-16. CrossrefMedlineGoogle Scholar72. Touchstone D, Beller G, Nygaard T, Watson D, Tedesco C, and Kaul S. Functional significance of predischarge exercise thallium-201 findings following intravenous streptokinase therapy during acute myocardial infarction. Am Heart J. 1988;116:1500-7. CrossrefMedlineGoogle Scholar73. . In-hospital mortality and clinical course of 20,891 patients with suspected acute myocardial infarction randomised between alteplase and streptokinase with or without heparin. Lancet. 1990;336:71-5. CrossrefMedlineGoogle Scholar74. Topol E, Burek K, and O'Neill W. A randomized controlled trial of hospital discharge three days after myocardial infarction in the era of reperfusion. N Engl J Med. 1988;318:1083-8. CrossrefMedlineGoogle Scholar75. Guidelines for the early management of patients with acute myocardial infarction. A report of the American College of Cardiology/ American Heart Association Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures (Subcommittee to Develop Guidelines for the Early Management of Patients with Acute Myocardial Infarction. J Am Coll Cardiol. 1990;16:249-92. CrossrefMedlineGoogle Scholar76. ACC/AHA guidelines for the early management of patients with acute myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures (Subcommittee to Develop Guidelines for the Early Management of Patients with Acute Myocardial Infarction. Circulation 1990;82:664-707. CrossrefMedlineGoogle Scholar77. Hemenway D, Killen A, Cashman S, Parks C, and Bicknell W. Physicians' responses to financial incentives. Evidence from a for-profit ambulatory care center. N Engl J Med. 1990;322:1059-63. CrossrefMedlineGoogle Scholar78. Hillman A, Pauly M, and Kerstein J. How do financial incentives affect physicians' clinical decisions and the financial performance of health maintenance organizations? N Engl J Med. 1989;321:86-92. CrossrefMedlineGoogle Scholar79. Yock P and Linker D. Catheter-based two-dimensional ultrasound imaging. In: Topol EJ, ed. Textbook of Interventional Cardiology. Philadelphia: W. B. Saunders Company; 1989;816-830. Google Scholar80. Grundfest W, Litvack F, Segalowitz J, Goldenberg T, and Forrester J. Angioscopy: technical details and clinical applications. In: Topol EJ, ed. Textbook of Interventional Cardiology. Philadelphia: W. B. Saunders Company; 1989 799-815. Google Scholar81. Chassin M, Brook R, and Park R. Variations in the use of medical and surgical services by the medicare population. N Engl J Med. 1986;314:285-90. CrossrefMedlineGoogle Scholar82. Leape L, Park R, Solomon D, Chassin M, Kosecoff J, and Brook R. Does inappropriate use explain small-area variations in the use of health care services? JAMA. 1990;263:669-72. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Eric J. Topol, MD; David R. Holmes, MD; William J. Rogers, MDFrom the University of Michigan School of Medicine, Ann Arbor, Michigan; the Mayo Clinic School of Medicine, Rochester, Minnesota; and the University of Alabama at Birmingham, Birmingham, Alabama. For current author addresses, see end of text. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byThe prevalence of erectile dysfunction among angiographically detected patients of coronary artery disease in North-IndiaEthics in American Health 2: An Ethical Framework for Health System ReformEthics in American Health 2: An Ethical Framework for Health System ReformAssociation between Erectile Dysfunction and Coronary Artery Disease: Matching the Right Target with the Right Test in the Right PatientThe Artery Size Hypothesis: A Macrovascular Link Between Erectile Dysfunction and Coronary Artery DiseaseCASE REPORT: Association Between Erectile Dysfunction and Coronary Artery Disease: A Case Report StudyDas akute KoronarsyndromOutcomes of patients with acute coronary syndromes and prior percutaneous coronary intervention: a pooled analysis of three randomized clinical trialsIs There a Link between Erectile Dysfunction and Coronary Artery Disease?Modern management of acute myocardial infarctionOutcomes research in the development and evaluation of practice guidelinesAge and the utilization of cardiac catheterization following uncomplicated first acute myocardial infarction treated with thrombolytic therapy (The Second National Registry of Myocardial Infarction [NRMI-2])Modern Management of Acute Myocardial InfarctionSignal-Averaged ECG in Noninvasive Assessment of Reperfusion in the Acute Phase of Myocardial InfarctionACC/AHA guidelines for coronary angiography11"ACC/AHA Guidelines for Coronary Angiography" was approved by the American College of Cardiology Board of Trustees in October 1998 and by the American Heart Association Science Advisory and Coordinating Committee in December 1998.22When citing this document, the American College of Cardiology and the American Heart Association request that the following format be used: Scanlon PJ, Faxon DP, Audet AM, Carabello B, Dehmer GJ, Eagle KA, Legako RD, Leon DF, Murray JA, Nissen SD, Pepine CJ, Watson RM. ACC/AHA guidelines for coronary angiography: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Coronary Angiography). J Am Coll Cardiol1999;33:1756–82433This document is available on the websites of the ACC (www.acc.org) and the AHA (www.americanheart.org). Reprints of this document (the complete guidelines) are available for $5 each by calling 800-253-4636 (US only) or writing the American College of Cardiology, Educational Services, 9111 Old Georgetown Road, Bethesda, MD 20814-1699. Ask for reprint No. 71-0164. To obtain a reprint of the shorter version (executive summary and summary of recommendations) published in the May 4, 1999, issue of Circulation, ask for reprint No. 71-0163. To purchase additional reprints (specify version and reprint number): up to 999 copies, call 800-611-6083 (US only) or fax 413-665-2671; 1000 or more copies, call 214-706-1466, fax 214-691-6342, or e-mail [email protected]A matched comparison of the combination of prehospital thrombolysis and standby rescue angioplasty with primary angioplastyRisk Stratification: Exercise Testing, Imaging, and Cardiac CatheterizationCritical Analysis of Coronary Artery Bypass Graft Surgery: A 30-Year JourneyInterventional Approaches to the Treatment of Acute Coronary Ischemic SyndromesChanging myocardial infarction population characteristics: Reasons and implicationsThrombolytic therapy for patients with prior percutaneous transluminal coronary angioplasty and subsequent acute myocardial infarctionDeterminants of the Use of Coronary Angiography and Revascularization after Thrombolysis for Acute Myocardial InfarctionModern management of acute myocardial infarctionCost-effectiveness of Routine Coronary Angiography After Acute Myocardial InfarctionPostthrombolysis noninvasive detection of myocardial ischemia and multivessel disease and the need for additional interventionAge-Related Differences in the Utilization of Therapies Post Acute Myocardial InfarctionRisk Stratification After Myocardial Infarction: Targets and ToolsThe influence of thrombolytic therapy on the predictive value of exercise testing 3 weeks after acute myocardial infarctionTreatment of myocardial infarction in the United States (1990 to 1993). Observations from the National Registry of Myocardial Infarction.Predictors of nonfetal reinfarction in survivors of myocardial infarction after thrombolysisImpact of age on clinical outcome and postlytic management strategies in patients treated with intravenous thrombolytic therapy. Results from the TIMI II Study. TIMI II Investigators.Current status of percutaneous transluminal coronary angioplastyStrategies for Reestablishing Coronary Blood Flow During the Acute Phase of Myocardial InfarctionOn-Site Cardiac Catheterization Facilities and the Use of Coronary Angiography after Myocardial InfarctionAssessing prognosis after acute myocardial infarction in the thrombolytic eraNoninvasive detection of reperfusion after thrombolysis based on serum creatine kinase MB changes and clinical variablesOverview of trends in heart disease changing prognosis after myocardial infarctionWanted: dead or alive. Assessment of myocardial viability after thrombolysis.Exercise thallium-201 scintigraphy after thrombolytic therapy with or without angioplasty for acute myocardial infarctionDirect angioplasty versus initial thrombolytic therapy for acute myocardial infarction: Long-term follow-up and changes in practice patternIs Survival in Acute Myocardial Infarction Related to Thrombolytic Efficacy or the Open-Artery Hypothesis?TIMI IIB follow-up. Lessons for clinicians and investigators.Thrombolytic therapy: Adjuvant mechanical intervention for acute myocardial infarctionLimitations of thrombolytic therapy for acute myocardial infarction complicated by congestive heart failure and cardiogenic shockCombination thrombolytic therapy: A comparison of simultaneous and sequential regimens of tissue plasminogen activator and urokinaseFatal Outcome After Unsuccessful "Rescue Angioplasty": Cause or Effect?The expected value of perfect information: cardiac catheterization after thrombolysis-is the value added greater than the cost? 15 May 1991Volume 114, Issue 10Page: 877-885KeywordsAngiographyAngioplastyCoronary angioplastyLungsMetaanalysisMuscular dystrophiesMyocardial infarctionMyocardiumRandomized trialsReperfusion ePublished: 1 December 2008 Issue Published: 15 May 1991 Copyright & Permissions© 1991 American College of PhysiciansPDF downloadLoading ...