A new study is on the way which would try to find out whether the standard approach to send a patient for “Percutaneous Coronary Intervention (PCI) only after the failure of clog-busting drugs after an hour or so or it should be observed on the routine basis to send the patients treated with the clog-busting drugs to a cardiac catheterization laboratory for follow-up PCI.
Percutaneous coronary intervention (PCI) is considered to be the best treatment for heart attack. It works on a combination of catheter-mounted balloons and stents to restore blood flow to the heart after unblocking the coronary artery. However the requisite is that PCI has to be performed rapidly which only few hospitals can achieve. Only the hospitals with a cardiac catheterization laboratory on site meet the 90-minute treatment goal.
During the ‘Late-Breaking Clinical Trials’ session at the SCAI Annual Scientific Sessions in Partnership with ACC i2 Summit in Chicago, the study “The Trial of Routine Angioplasty and Stenting After Fibrinolysis to Enhance Reperfusion in Acute Myocardial Infarction” (TRANSFER-AMI) has been reported.
Dr. Warren J. Cantor, Medical Director of the ‘Interventional and Invasive Program(IP)’ at Southlake Regional Health Centre, Newmarket, Ontario says that contrary to the previous studies, there is enough evidence to believe that it is safer and more effective to perform PCI after thrombolytic therapy. Warren puts stress on this as only handful of hospitals in North America has PCI facilities. It was reported in the earlier studies that it might not be very beneficial, rather could be harmful to perform PCI after treating the patients with clot-busting drugs, termed as thrombolytic or fibrinolytic agents.
Under the study TRANSFER-AMI, Dr. Cantor and his team mates conducted a random investigation is the largest-ever randomized trial to investigate the above apprehensions raised in the previous studies. 1,060 high-risk patients with “ST-Segment-Elevation Myocardial Infarction (STEMI)” or large or complicated heart attack were randomly selected for the study. They were transferred to PCI after 6 hours or in case of development of any further complication after an observation of 60 to 90 minutes after they were already being treated with tenecteplase, a clot-busting drug. The two groups of patients would be further evaluated for the factors like death, repeat heart attack, recurring ischemia, heart failure and shock for a period of 30 days.
Dr. Cantor put stress on health institutions to plan design the strategies in a way that it can facilitate shifting the patients to a hospital. Many hospitals have difficulty getting patients to the cath lab within cardiac catheterization laboratory within six hours.
The Society for Cardiovascular Angiography and Interventions at Washington, DC has a large group of 4000 cardiologist operation in over 60 countries as their members. The American College of Cardiology imparts training in regards to cardiovascular care and well being.
SCAI-ACCi2 offers a common forum to the cardiovascular practitioners and is funded by the Society for Cardiovascular Angiography and Interventions (SCAI) in association with the American College of Cardiology (ACC).
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