Fibrinolytic therapy percutaneous coronary intervention

Early reperfusion therapy with either primary percutaneous coronary intervention or administration of a fibrinolytic agent within 3 hours of symptom onset is the recommended therapy for patients presenting with ST-segment elevation acute coronary syndrome. 

Sabatine MS, Cannon CR Gibson CM. Clopidogrel as adjunctive reperfusion therapy (CLARITY)-thrombolysis in myocardial infarction (TIM I) 28 investigators. Effect of clopidogrel pretreatment before percutaneous coronary intervention in patients with ST-elevation myocardial infarction treated with fibrinolytics the PCI-CLARITY study. JAMA 2005 294(10) 1224-1232. 

Nallamothu BK, Bates ER. Percutaneous coronary intervention versus fibrinolytic therapy in acute myocardial infarction is timing (almost) everything Am J Cardiol 2003 92(7) 824-6. 

Although the therapeutic benefit of coronary reperfusion—fibrinolytic therapy and primary percutaneous coronary intervention (PCI)—for the treatment of acute ST elevation myocardial infarction (STEMI) in younger patients is well established, there remains considerable debate over the appropriate choice of a reperfusion strategy for elderly patients. 

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