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Original Article

. 2018; 9(1): 28-31

Primary PCI versus Pharmaco-Invasive Strategy in Patients with ST-Elevation Myocardial Infarction; a Randomized Clinical Study

Ahmed Bendary, Wael Tawfek, Mohammed Mahros, Mohamed Salem.

Background: It is debatable whether immediate fibrinolysis followed by timely coronary angiography, provides a clinical
outcome similar to that with primary percutaneous coronary intervention (PPCI) early after acute ST-segment elevation
myocardial infarction (STEMI). Methods: During period from December 2016 to June 2017, 60 patients with STEMI were
randomly assigned to undergo either primary PCI (Group I) or immediate fibrinolysis (Group II) with subsequent coronary
angiography with PCI within 3 to 24 hr later. The primary end point was a composite of all-cause death, re-infarction,
and target-vessel revascularization, re-hospitalization for cardiac reasons, any stroke and major bleeding up to 30 days.
Results: The primary endpoint was reported in 23% of patient who had PPCI versus 33% in those who had pharmacoinvasive
strategy (RR= 0.7, 95% CI 0.31-1.58, P= 0.46). Delay time from symptom onset to each of the two reperfusion
strategies was shorter in group II than group I (110 27.5 versus 186.8 16.6 mins respectively, P

Key words: Fibrinolysis, PCI, Reperfusion, STEMI.

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