PMID- 36825458
OWN - NLM
STAT- MEDLINE
DCOM- 20230403
LR  - 20230403
IS  - 1744-8344 (Electronic)
IS  - 1477-9072 (Linking)
VI  - 21
IP  - 3
DP  - 2023 Mar
TI  - Safety and efficacy of intracoronary thrombolytic agents during primary 
      percutaneous coronary intervention for STEMI.
PG  - 165-175
LID - 10.1080/14779072.2023.2184353 [doi]
AB  - INTRODUCTION: Large thrombus burden in patients with ST elevation myocardial 
      infarction (STEMI) is associated with higher rates of distal embolization, 
      no-reflow phenomenon, abrupt closure, stent thrombosis, major adverse 
      cardiovascular events (MACE), and mortality. Intracoronary (IC) thrombolytic 
      agents are theoretically attractive as an adjunct to primary percutaneous 
      coronary intervention (PPCI) as they activate endogenous fibrinolysis which 
      results in degradation of the cross-linked fibrin matrix in coronary thrombus. 
      AREAS COVERED: We reviewed published studies reporting on intraprocedural 
      anti-thrombus strategies used during PPCI including randomized controlled trials 
      and observational studies. EXPERT OPINION: Published studies are limited by small 
      sample size and heterogeneity due to variation in indication, inclusion criteria, 
      thrombolytic agent, dose, delivery mechanisms, antiplatelet and anticoagulant 
      regimen, timing in regard to reperfusion, PCI techniques, and endpoints. Despite 
      these limitations, data are consistent that IC administration of thrombolytic 
      agents at low doses is associated with low rates of bleeding and vascular 
      complications. While there is currently no compelling data demonstrating a 
      benefit to the routine use of IC thrombolytic therapy in patients with STEMI, 
      there is suggestive data that IC thrombolysis may have benefit in selected 
      patients.
FAU - Kulick, Natasha
AU  - Kulick N
AD  - Division of Cardiology and the McAllister Heart Institute, University of North 
      Carolina, Chapel Hill, NC, USA.
FAU - Friede, Kevin A
AU  - Friede KA
AD  - Division of Cardiology and the McAllister Heart Institute, University of North 
      Carolina, Chapel Hill, NC, USA.
FAU - Stouffer, George A
AU  - Stouffer GA
AUID- ORCID: 0000-0001-8208-8998
AD  - Division of Cardiology and the McAllister Heart Institute, University of North 
      Carolina, Chapel Hill, NC, USA.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20230303
PL  - England
TA  - Expert Rev Cardiovasc Ther
JT  - Expert review of cardiovascular therapy
JID - 101182328
RN  - 0 (Fibrinolytic Agents)
SB  - IM
MH  - Humans
MH  - Fibrinolytic Agents/adverse effects
MH  - *ST Elevation Myocardial Infarction/drug therapy
MH  - *Percutaneous Coronary Intervention/adverse effects
MH  - Treatment Outcome
MH  - Thrombolytic Therapy/adverse effects/methods
MH  - *Thrombosis/etiology
OTO - NOTNLM
OT  - STEMI
OT  - intracoronary
OT  - primary PCI
OT  - thrombolysis
OT  - thrombus
EDAT- 2023/02/25 06:00
MHDA- 2023/04/03 06:41
CRDT- 2023/02/24 04:24
PHST- 2023/04/03 06:41 [medline]
PHST- 2023/02/25 06:00 [pubmed]
PHST- 2023/02/24 04:24 [entrez]
AID - 10.1080/14779072.2023.2184353 [doi]
PST - ppublish
SO  - Expert Rev Cardiovasc Ther. 2023 Mar;21(3):165-175. doi: 
      10.1080/14779072.2023.2184353. Epub 2023 Mar 3.