Stenting and fibrinolysis

LONDON, August 11 (SPIS MedWire) In patients with acute myocardial infarction, coronary stenting plus abciximab results in a greater degree of myocardial salvage than fibrinolysis with alteplase, according to a report in the New England Journal of Medicine. Schomig and colleagues at Deutsches Herzzentrum, Munich, studied 140 patients with AMI who were randomly assigned to receive either a stent plus blockade of platelet glycoprotein IIb/IIIa receptors with abciximab (Reopro) or accelerated infusion of alteplase (Actilyse), a tissue plasminogen activator. In the stent plus abciximab group, the median size of the final infarct was 14.3% of the left ventricle, compared with 19.4% in the alteplase group. The authors say the difference was due to a larger salvage index — that is, the percentage of the left ventricle that was salvaged divided by the percentage that was compromised by the initial perfusion defect — in the stent group. The combined incidence of ...